going to have biopsy soon

Raising PSA, was 1.96 in Sept 2022 and then 3.27 in November 2023
Had a MRI that showed one small Pi-rad 4 lesion in the left posteromedial peripheral zone

Prostate volume=25 ml

Transition zone: no significant benign prostatic hypertrophy. no focal significant finding identified
Peripheral zone: diffusely heterogeneous signal. Focal findings below

Lesion: size 6 mm by 4 mm
T2:3/5
DWI: 3/5
Prostate margin: indeterminate
Lesion overall Pi-rads category 4/5

Extra prostatic Extension:
Neurovascular bundle: (approximate distance from any pi-rad 4 lesion): 1mm
Seminal vesicles: unremarkable
Lymph nodes: no pathologic lymph node enlargement identified
Other pelvic organs: N/A

I have to wait 3 weeks for a biopsy. Ugh. hard to wait. what do you think?
Thanks

Looking back on my own experience, Rule #1 is don't panic and let the emotions take control. I know. Easier said than done. One hour at time. I had to go through 4 biopsies before they found my 3+4 which led to my decision to pull the trigger and let them cut on me. No MRI for me. By the time they pulled it out EPE had developed. But that was way back when. Yet, by the grace of God, still undetectable 8 years later. You're doing exactly what you need to do. May be much ado over nothing. You don't give your age, so not sure about the PSA rise. But at least the ones with the MD after their names have an idea of what to look for when your time comes in 3 weeks. Meanwhile, be kind to yourself. Eat healthy, get a little exercise, do the things that bring you joy and as soon as your head hits the pillow at night be thankful for all that you have - then sleep well. All the very best to you, and keep the board advised on how your doing. Btw, for me the biopsies were no big deal. The hardest part was driving the freeways and making it to the clinic on time. A few little pinches and it was over.

I was diagnosed a couple years younger than what you are. On active surveillance for about 5 years. I was referred by a PCP to urology after my PSA jumped from about 4 to a little over 6. I knew next to nothing about Pca or PSA at that time. I just figured that I'd let the experts handle it. Had I known at that time what I know today, I would've probably asked for a urology referral earlier. I was told that a PSA 4 or below for a guy my age was normal, and that an enlarged prostate can cause PSA to rise. The DRE indicated I had an enlarged prostate. Now I understand that it's not so much the raw number, but the rate of increase over time that's important. Thinking back, I believe it took a couple years for me to go from 4 to 6. But there was a slow gradual increase in previous years. I wish I had been offered an MRI. No such luck. But this was over 10 years ago. I was treated at the VA - and when I brought it up, was told they didn't have MRI for the prostate available. Again, had I known then what I know today, I would have paid for one out-of-pocket. Oh well. Still turned out okay. I'm very thankful for the treatment I received. In your case, much more information is available to your providers. All the best you to you in 3 weeks and Godspeed.

JR…A day or two following my biopsy I got a call from urologist saying my biopsy was positive for cancer and to schedule an appointment with his office to discuss treatment. The earliest available appointment was six weeks out. Although in panic mode at the time of the phone call the delay was a blessing. I used that time to learn about prostate cancer and treatment options. This forum and the people contributing to it was a tremendous help. When I sat down with my urologist to discuss treatment options he was ready to schedule a radical prostatectomy even though I was a low volume Gleason 6. What a mistake that could have been. I learned from that meeting that a general urologist (at least mine) may not be an expert in PCa. It was here that I first learned about numerous radiation options, surgical options, active surveillance and where to get additional information. I was able to make a fully informed treatment decision.

One of the challenges of a prostate cancer diagnosis is wading through all the various treatment options. Each option including active surveillance does carry some risks of unwanted side effects. My wish each recently diagnosed guy would explore and weigh the various treatments and make a very informed decision. This is a great place to learn and ask questions. Although the people here in most cases have very little formal medical training they make up for it with a passion to defeat PCa. Best wishes. Terry