Hi English Teacher,
At your age, it may be prostatitis. What has your doctor done to rule that out? (I'm assuming you didn't have sex or go bike riding within 48 hours of those PSAs). Did the path reports show any evidence of chronic inflammation? Prostatitis is hard to diagnose and may be hard to treat. It often does not respond to antibiotics, which I assume you've tried by now.
You can have the new
PHI blood test as an additional biomarker. It is less affected by prostatitis. A
PCA3 urine test, given after a prostate massage is also available. Both of these are covered by insurance. The urologist can also ask the pathologist examine the prostatic fluid from that test for infectious agents.
Unless you have reason to believe that your elevated PSA is caused by something else, and I think you should rule those out first, I think an mpMRI is a great idea. In the right hands (and I assume MD Anderson would have those right hands), it is an excellent tool for locating higher grade cancers. They typically will fuse the image with a real-time ultrasound to guide a future biopsy, and they take a random sample too. The "fusion biopsy" is typically transperineal, which enables it to get at parts of the prostate impossible to reach with an ordinary transrectal TRUS biopsy. It has lower infection rates too.
- Allen