My concern, in this case, is that whatever has been uncovered by the MRI might be artificially elevating the PSA, which might result in erroneously classifying the patient into a higher risk category, leading to more treatment than is necessary. Personally, I have never seen a clinically significant...

I don’t recall encountering this situation. If described by the diagnostic radiologist and is symptomatic, antibiotics for a month and repeat the MR and PSA. I don’t think that they would likely change. That said, I’m often wrong!

I would stage the patient per usual based on Gleason Score and staging workup and plan on treatment accordingly. I would also try to identify the cause of prostatitis since if the patient desires radiation treatment, my experience has been that these patients have more bothersome voiding symptoms. M...