Recheck PSA prior to biopsy?

The PIRADS 3 is something you do want examined. PSA is a little high, but the prostate isn’t that huge that a 6.2 is normal. Did you have antibiotics to reduce the BPH so that your prostate would get smaller? That could explain why it’s dropped from 10.7.

Some more things to consider.

A 13% free PSA is a problem and likely indicates a higher risk for prostate cancer, especially with a total PSA of 6.2 ng/mL. Doctors typically recommend a biopsy if the percent-free PSA is 10% or lower, and may suggest it if it's between 10% and 25%. This is because a lower percentage of free PSA is more strongly associated with an increased chance of prostate cancer.

Sounds like the fusion biopsy is a real positive choice.

A fusion biopsy for prostate cancer is done by combining a pre-biopsy MRI with a real-time ultrasound to precisely target suspicious areas in the prostate. The process involves an MRI scan where a radiologist marks suspicious spots, followed by a local anesthesia-administered biopsy where a urologist uses a fusion system to overlay the MRI images onto a live ultrasound view.

You might want to consider a PSE blood test from Oxford Biodynamics. 94% accuracy vs PSA alone which is about 55%. It will tell you if you are likely or unlikely to have cancer.

I'm in a similar situation. My PSA this year was 8.1 in Jan and 4.4 in June. Then back up to 7.1 in October. First MRI was a Pirads 3 with a 95ml prostate and my second MRI was a Pirads 2 with a 70ml prostate. My urologist still believes I would benefit from a biopsy but he also said there is nothing to target. So I'm doing another PSA in December and paying attention to prostate density and any upward trends in my PSA. My free PSA was 13.5% but went up to 17.8%.

@ezupcic
A large prostate can cause a lot of PSA issues, As you have seen.

You could get a PSE test. It will recognize whether or not you have prostate cancer and need a biopsy. It is 94% accurate. Ask your doctor about getting one.

I wish the PSE were a standard of care option because my urologist and PCP are not very familiar with it and none of the local labs offer it.

Thanks to all for the great thoughts. I did have some antibiotics in between the two tests - just amoxicillin - not known for its great prostate penetration. I’ll wait for this urine biomarkers test and the re-read of my MRI - it’s uncomfortable being in this prolonged nebulous diagnosis phase but im sure it’s better than definitely bad. All the best.

If you do it - do one that is MRI and ultrasound guided ! Also, make sure it is transperineal by all means. If you do have lesion visible, I do not understand why you were advised not to have biopsy. My husband had PSA 5.7 and than it went to 7.6 and than fell to 5.2 etc. and very big prostate - still his cancer proved to be highly aggressive. We were explained that gleason 9 often produces less PSA than gleason 7 (!!!) , so please maybe look for third opinion or just do that biopsy and be done with this limbo situation. : (
Wishing you the best of luck !

@ezupcic you have to go online and ask for more info; they may even contact your doc or tell him where to send your blood for the test.