u/SquirrelsGoneWild6

Long story short, I am 63, healthy, run and workout 5-6 times a week, I had a PSA of 4.39 up from 3.9 the year before, so my doc sent me to a urologist. Next PSA 2 months later a 5.3, MRI clear, but ExoDx a 46. So a biopsy was ordered and showed 2 of 12 cores as hits, one a 3+4, the other a 4+3 but the urologist was skeptical of the 4+3 given only 2 hits and the PSA. So we did a PSMA PET scan which showed "intense activity at the posterolateral left prostate lobe near the mid gland". So, 1 side only. Decipher score of .24 (low risk).

The Decipher report also shows that these conditions could warrant AS vs. treatment at least initially. With data also showing a 0.4% risk of metastasis in 5 years and 1% risk of metastasis in 10 years.

That data seems to show AS is not a bad option in the short term but at the same time, there is that 4+3 that is getting a second opinion but if the second opinion comes back 4+3, then what? Does Decipher trump Gleason?

I have not had a f/u with the urologist since the PSMA and Decipher results came in but that happens next week.

I am strongly leaning toward a radiation therapy, likely LDL Brachy, just to make sure we kick this thing in the nuts (no pun intended). But at the same time if the Decipher report is accurate and the doc says I am much more likely to die from something other than prostate cancer in 15-20 years even with AS, I don't know what makes sense any more

Just got my biopsy results yesterday. The doc had not posted them before our follow up so I was pretty sure that there was a positive hit. And, yep, 2 cores hit out of 12. Some history below on test results before biopsy for those in similar situations. It has been a roller coaster of nerves for the past couple of months with conflicting test results, not knowing if you have it or not. But I was able to find calm in knowing, if its cancer, its found early and I would rather know now rather than go through multiple biopsies every time my PSA goes up.

Some history:

I am 63 with no symptoms and no family history

• My annual blood test in Dec 2025 showed a PSA of 4.39 (was 3.9 the year before) so I was recommended to a urologist.
• In mid-Jan 2026 met with urologist. took another PSA and it went down to 4.15. Urologist recommended MRI.
• MRI in mid-Feb 2026 came back clean with a PI-RADS of 2, no lesions, no signs of tumors, no signs of spreading, but signs of enlarged prostate due to BPH. Prostate size estimated at 32mL
• Urologist recommended an ExoDx and another PSA in late Feb. PSA was 5.3 and ExoDx came back at 46.38.
• the Urologist ordered a biopsy and here we are

Before biopsy, the doc said my odds were between a 30-50% chance of an aggressive cancer.

Bottom Line:

• PSA went from 3.9->4.38->4.15->5.3
• PI-RADS = 2
• clean MRI
• ExoDx = 46.38

Now that I know, I feel much better actually. No more anxiety. I have accepted it and looking to take the next steps. Thanks to all of the posts on this board which has helped a lot plus reading about Ben Stillers experiences has also helped a lot.

Of the 2 cores that had a hit, 1 was 3+4 Gleason 7, grade 2, and the other was a 4+3 Gleason 7, grade 3. Both in different areas. I don't have the official report to provide details of percentages and all as he has not posted them yet. The doc said the chances of any spread at this point is extremely unlikely but to wait for the PSMA results just to be 100% sure

Next steps are PSMA PET scan and a genomic test of the cells themselves. I have not read much about the genomic tests and if its worth doing when a grade 3 is involved. He said he wanted to get a good idea of the behavior of the cells before determining if treatment is needed or to go on AS for awhile. Seems we should just get the PET scan and decide on treatment from there