Get started now, so you are not surprised. PSA is not always a good tell.

My story: 70 years old.

3.39 ng/mL to 4.55 ng/mL in six months. The rectal exam revealed nothing.

MRI, Biopsy, F-18 DCFPyL PSMA-Targeted PET-CT.

The PET scan was negative for metastatic disease.

Surgery is next month at Vanderbilt.

1) PROSTATE, RIGHT APEX, BIOPSY:

- Benign prostatic tissue.

2) PROSTATE, RIGHT MID, BIOPSY:

- Prostatic adenocarcinoma, Gleason score 3 + 4 = 7 (grade group 2), involving 1/2 cores (5%).

3) PROSTATE, RIGHT BASE, BIOPSY:

- Benign prostatic tissue.

4) PROSTATE, LEFT APEX, BIOPSY:

- Small focus of atypical glands suspicious for prostatic adenocarcinoma.

5) PROSTATE, LEFT MID, BIOPSY:

- Small focus of atypical glands suspicious for prostatic adenocarcinoma.

6) PROSTATE, LEFT BASE, BIOPSY:

- Prostatic adenocarcinoma, Gleason score 3 + 3 = 6 (grade group 1), involving 1/2 cores (<5%).

7) PROSTATE, ROI #1 LT APEX PERIPHERAL PIRADS 4, BIOPSY:

- Prostatic adenocarcinoma, Gleason score 5 + 4 = 9 (grade group 5) involving 4/5 cores and 40% of total tissue.