The time and expense involved in having all these tests may seem like a lot of effort in order to avoid a biopsy.  Based on what I’ve learned so far, an invasive “random” biopsy (with its associated risks) still doesn’t seem like the best course of action for me, given my results so far.  Alone, PSA levels, DRE, a PCA3 test, a power doppler ultrasound or a 3T MRI scan may not be any better than a biopsy as a method to rule out cancer.  Combined, I suspect they could indeed be enough to detect cancer with a reasonable degree of sensitivity.  Plus, in the case of the ultrasound and MRI, they may also even be able to help guide a biopsy to a suspicious location.

There’s another reason all these tests may come in handy.  Even if I don’t have cancer, I know something is up with my prostate.  It might be prostatitis, it might be BPH, it might just be the way I was born.  Years from now, I may start to have another prostate issue.  In fact, a large number of men do get prostate cancer at some point in their lifetime.  What I will have now is a baseline for PSA, PCA3 and MRI results to compare to any lab results in the future.  I had hoped to have the same for ultrasound results, but that has been a disappointment so far, but I’m not sure if that is related to the physician, the ultrasound technology itself or both.  Anyway, these results can also help detect changes that might be important and rule out anything that may not be of concern because it hasn’t changed much over time.

At the very least, I’ll probably have my PSA level checked every 6 months to a year.  If PCA3 testing becomes more widely accepted, perhaps I will do that annually, also.  If one or both of them go up significantly, then it might be time for some other action.  Of course, this all depends on the results of my MRI/biopsy next month.