On AS third biopsy

Hello all
Been a while. On mon headed into my third biopsy(including original). Last one neg and original g6 1core 5% with 4.3 psa. Since psa every 3mo running between 3 and 3.5
But last psa 5/22 was 4.2 a dissapointment retest 6/15 3.9 so maybe one time uptick
Hoping for another neg biopsy
If so would like to figure out if safe to spread out more.
Also 2 mri pirads2 no lesions both the same done on 6/18 and 1/20. Interested on opinions on this
Also switched provider within same org. Seeing RN of a urologist specializing in oncology. Was a bit concerned at first but she is very informative and easy to talk to
Some people seem to get annoyed when you ask questions. Not her she loves to discuss

Well thanks and wish everyone the best

Spreading out your testing is reasonable.

At this point, a suggested regimen would be PSA every six months, DRE at one year. MRI every two years, and biopsy at 3-4 years if other tests are not suspicious.

ASAdvocate
Like youre approach although would prefer to do PSA every 3 months at least in the near term. No necssariy that I would miss an uptrend if I did not but would like more info on variability. This would help in interpreting any data trends. Oh yes I am an analytical chemist and luv data.

thanks much for youre input-deeply appreciated

Johns Hopkins, which sponsored PHI’s FDA approval application, has dropped using it for their AS program. They now only use PSA and PSADensity for six month monitoring.

Djin
Interesting link and concepts
Not sure how to apply to my situation and ad 2019guy says a bit abstract
But agree one plan does not fit all but need to evaluate risk level and adjust testing accordingly
You have any specific insights on this article

Thanks for responding

Djin
Thanks
Agree best to stick with docs recomendation but mechanism to asses risk level and atennuating testing, in particular biopsy(greatest risk) makes sense
In my case with 1 positive biopsy g6,1core5% with stable psa and pirads2 clean mri does not(long term) does not require the scrutiny of a g62core 20% with higher and slow rising psa and mri with suspicious lesion.
Of course meed to do evals to establish that that origimal state is accurate
Hopefully biopsy tomorrpw will c OP me out good then eill have some meat for dicusion
If not i move on from there

Thanka again

I've been on AS for close to 3 years. Currently, PSA every 3 months enrolled in PASS Study; DRE at least once a year; MRI annually and biopsy discussion if something dramatically changes. I take it as it goes.

Good luck with the biopsy. Will it be directed or random?
This is my 12th year in an active surveilance program. Every six months i receive a dre, a psa and a free psa. Every two year a T3 Mei is done and a directed biopsy is performed using the results of the MRI. In my case when a small amount of a G4 was found one year another biopsy was done the following year to triangulate the area where the G4 was found to determine how extensive the G4 was in the area.

I live in seal beach, CA. I am treated at a center of excellence, ucla. I was one of the first patients treated in the active surveilance program where an Artemis three dimensional biopsy Machine is uses. It has the capability to lock the results from a T3 MRi to direct the biopsies.
Instead of seeing local urologists, i drive 35 miles each way in very horrible freeway traffic(and I really mean horrible) to get the best care