New Here: Haven't been diagnosed yet going to urologist soon

Your free PSA does imply that you have a lower risk of prostate cancer. Having your PSA go down so much could mean that you had an enlarged prostate and BPH and that antibiotics or life has allowed it to be smaller And allowed your PSA to be lower.

Normally, an MRI would allow them to see whether tumors are in your prostate, and can give a score as to how risky they are. If the doctor doesn’t bring it up, you should mention that you’d like to have one. You need to be proactive with prostate cancer and Direct your treatment as much as possible. At this point a biopsy would not be the most logical first step.

The other symptoms are unlikely to be prostate cancer. Erectile dysfunction is unusual with an early prostate cancer diagnosis. If you’ve been riding a bike a lot with the bike seat Pushing into your perineum that can cause ED. Severe constipation is not a sign of prostate cancer normally. Back pain can be for many issues.

When you go to the urologist, be aware that your specific symptoms do not necessarily point to prostate cancer.

@jeffmarc ,
Thank You, Jeff.
Your words help a lot.
I appreciate you taking the time to give me advice.
Hopefully, everything goes as you say 👍
Thank You again

As Jeff said, get an MRI. DRE's are not that reliable. My urologist said if he felt 100 prostates today, mine would be the most normal. MRI found my Gleason 4+3.

@jcf58
Yes... I have one scheduled Dec 10th.
We'll see.
Urologist performed an ultrasound in her office this morning.
Everything looked good, but I have a very enlarged prostate...
I'm guessing if there any abnormalities with the prostate, she would have seen them...

You may want to do a PSE blood test. It claims 94% accuracy and its purpose is to tell you whether you are likely... or unlikely to have prostate cancer. It can also help you and your doctor decide whether a biopsy is required. The test is from Oxford Biodynamics. The VP of Diagnostics is/was Joe Abdo. His email is joe.abdo@oxfordbiodynamics.com. Not sure he is still there but there are several people there that will take phone calls as well so you can ask questions.

@bens1 ,
Thank You, Ben.
I truly appreciate your words and advice.
I retired to Spain.
So I don't believe I can have the PSE test.
Let's see what the MRI tells me....

Just because you have a PSA higher than 4 does not necessarily mean you have Prostate Cancer. My PSA usually runs 7 to 9, but I have been diagnosed with PC, Gleason 6, and have been on active surveillance for 5 years with no change so far.

@bbmack , did you have an MRI and if so what was your Pirads score? I've also heard that an enlarged prostate produces more psa which may in part explain higher psa numbers. With a Gleason 6 how did you decide on active surveillance?

@bbmack
That is great that your PSA hasn't changed, especially not going up.
All I have had is good news, but the MRI will be the defining factor.
Fingers crossed 🤞

There are a dozen things that can cause PSA to bounce around. If it were me, I’d ask my medical team to rule out those things first.

Is all of your other bloodwork normal - CMP, CBC, etc?

I would consider the easy things first…..