This was posted a while ago. Any updates? I have tried to read about asymmetrical prostates and what I've gathered from my informal research is that it is common and not necessarily linked to prostate cancer. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1464-410X.1997.00155.x I would guess they are being cautious and want to evaluate further. I personally would work with your doctor and do as they recommend, however, if you are not confident in the first doctor's findings or recommendations, get a second opinion. Let me know how this went down since it has been a few weeks.
I just answered another Q here on MedHelp re: whether to do a biopsy. I’m a prostate cancer patient myself, had surgery last yr (07/31/18). I had a high PSA, didn’t want to do a biopsy unless there was a very strong chance I had cancer (my DRE found nothing unusual) so I requested a PHI test = Prostate Health Index, it’s a simple blood test that is WAY more accurate than PSA alone. It measures PSA along w/ 2 other factors & the 3 together generate a number. Under 24 means 50% chance of cancer. SkipNBeat, I don’t know whether you’ve already had the biopsy, but if not, ask your Dr. for this test 1st, then if your # puts you at risk, go ahead w/ the biopsy. In my case, my # came back at 68, which meant I was at very high risk, so I did the biopsy, which confirmed the cancer. I don’t know why Dr’s don’t routinely order this whenever Prostate cancer is suspected - it’s quick, non-invasive & way less expensive than either a biopsy or MRI. If you have not already had the biopsy, please insist on PHI 1st, then the biopsy if you’re at high risk...
Here's an eye opener, at least to me, from McMaster in Canada.
--Digital Rectal Examination for Prostate Cancer Screening in Primary Care: A Systematic Review and Meta-Analysis-- 2018
"Recommendations regarding prostate cancer screening have been inconsistent. The Canadian Urological Association recommends screening with both DRE and PSA in all average-risk men aged 50 years and older with a minimum life expectancy of 10 years. In contrast, the Canadian Task Force on Preventive Health Care recommends against use of the PSA test for prostate cancer screening in men aged 55 years or older without a previous diagnosis of prostate cancer."
Their CONCLUSION: "Given the considerable lack of evidence supporting its efficacy, we recommend against routine performance of DRE to screen for prostate cancer in the primary care setting."