Active Surveillance But Rising PSA

I had my first biopsy 4 years ago due to a rising PSA ( 3.5 to 6). Pathology showed one core at 20% with a Gleason score of 6 (3+3). Started active surveillance with PSA check every 3 months. PSA went back down to 4.5 the first year. Since then I have had 3 more biopsies due to slow rising PSA. Most found in any of these biopsies was 2 cores- one at 20% and one at 5% with both being Gleason 6 (3+3).

Urologist put me on Flomax and Finasteride one year ago. PSA was at 4.6 after 3 months but was told you have to double that when on Finasteride. My urologist told me that is equal to a PSA of 9.2. I go back for another PSA test in a couple weeks. Urologist said if PSA reach a 10 that I need to decide on a treatment. The Finasteride is supposed to shrink the prostate but when I asked about the size of my prostate after my last biopsy he told me it was 45 cm. That is the same size that it was 3 years ago so now I am confused.

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