What do you think comes next for me?

Purely a guess and I’m not a doctor or even very well-versed in all the ins and outs of PCa (I get bogged down in details fairly quickly and zone out), but maybe another biopsy, like a more targeted one, or a saturation biopsy?

Thanks! That suggestion makes sense. From everything I am reading, it seems there is more to learn about my prostate before there can be a high degree of confidence in one approach or treatment.

This does look a little chancy. The PIRADS Score doesn’t really imply you have a cancer. They normally would take 12 cores, but they only took 10. They only do about one percent of the prostate so it is likely there is something else going on in there and that is because.

High-grade prostatic intraepithelial neoplasia (HGPIN) on a prostate biopsy means that cells lining the prostate glands look abnormal (high-grade) but have not yet invaded the surrounding prostate tissue, indicating a potential precursor to cancer rather than cancer itself. While not cancer, it warrants close monitoring and potential rebiopsy, as it can be found alongside prostate cancer.

Another biopsy of the area that showed this abnormality would make sense.

If your most recent PSA was Jan 26, what comes next now is another PSA test to see how fast it is. Active surveillance is your friend. Perhaps a wider sampling, targeted biopsy at some point. Certainly, a conversation for your Dr. (which I am not one of BTW). Also, at this point, I think any treatment decisions are going to be highly age dependent. Best wishes.

Probably active surveillance. ISOPSA barely indicated cancer. You PSA is not very high especially if > 65. PIRAD2 is benign 80% of the time. Unless your PSA was under 3 a year ago and is rapidly rising why do another biopsy? All prostate cancer treatments have negative side effects that will lower your quality of life so why rush into treatment? You could get a second opinion on your biopsy to see if it is upgraded. If your PSA continues to increase than get another mpMRI and see if a targeted biopsy is warranted. Were there any notes in the biopsy report that indicated an aggressive cancer?

@jeffmarc Thanks for replying. I should have included more details. The biopsy covered 10 areas of my prostate. The test results indicates 28 cores taken from those ten areas. Six of the 28 cores were adenocarcinoma.

@jim18 Thanks for replying. I'm 72, by the way. I guess I'll see what the doctor says on Monday.

@kevinm4
With that many cores taken it’s definitely sounds like you should wait six months before you do anything more. What’s your doctor think about this? With just 3+3 Holding off doing anything for a while sounds like the best bet. You definitely don’t wanna get treatment when you don’t need it.

Has your PSA been rising at a significant rate? They don’t mention that at all. Your doubling rate is what really counts At this point.

@jeffmarc Last year in January I was at 4.06. This year in January I was a 5.33. I think that is a doubling time of 38 months.

@kevinm4 I guess I did something wrong. A doubling calculator indicated it would be 30.6 months.