PSA 10.9 - Do I need PSMA Petscan?

[cederpicket]

60 years old, My total PSA reading is 10.9 and free PSA of 1.1. In May 2024 it was 5.09 and 1.34 . In Sep 2023, it was 3.95 and .86. I was treated for prostatitis earlier with Doxycycline by the urologist (took it for 2 months). I am under TRT. ( Dose of 75Mg/week) .

I had a Prostate MRI scan in Sep 2023 - results below

The prostate is enlarged in size and measures 4.6 x 4.0 x 3.2 cm with a volume of 35.3 cc. Prostate density is 0.1 ng/ ml2(normal range is <0.10 ng/ml2, prior negative biopsy - < 0.15 ng/ml2).

IMPRESSION: Multiparametric multiplanar MR imaging of prostate reveals changes of chronic prostatitis against a background of benign hypertrophy of prostate (PIRADS - 2)

I did have few ejaculations 5 days before blood draw last week. Also eating High Protein diet /weight lifting, Not sure if this impacted the result?

Should I do a PSMA Petscan or instead Repeat MRI?

Thank you

[Tall_Allen]

You have prostatitis, not prostate cancer, let alone advanced prostate cancer. Antibiotics have no effect on prostatitis.

[Bigdo58]

You are completely ok. Don't worry at all about the cancer element - so far anyway. TA is absolutely correct.

[cederpicket in reply to Bigdo58]

Thank you so much. So how do i reduce my PSA?

[Bigdo58 in reply to cederpicket]

You don't have to do anything. That is unless you are suffering invasive QOL symptoms of your enlarged prostate. So, urologist discussion, maybe a turp? transurethral resection...bits off basically.

[NanoMRI]

Interesting how folks diagnosis and from a bit of text. Based on my experiences, depends on how proactive you want to be to achieve early detection if cancer begins? MRI's can miss cancer, so can other imaging methods. IMO nothing wrong with annual imaging, second opinions of imaging, and liquid blood biopsy testing, to be more certain.

[Justfor_]

If we employ the established magic numbers of the free to total PSA ratio, you have one benign (26% > 25%), one undeterminable (21%) and one malignant (10% < 15%). IMO, you are on the fence.

[cederpicket]

Thank you. Just met the urologist. He requested for another PSA test in a months time to evaluate further. No MRI needed as per him.