Please ask the specialists among you what are the most likely diagnoses in a 67yo WM with a PSA of 11, %fPSA of 24%, normal CBC and diff, but a very high ESR 140 mm/hr and normal CRP , normal protein electrophoresis, normal DSDNA but mildly positive ANA. He also has a very large prostate (175 cc by transabd ultrasound) with attendant LUTS, a normal (dipstick) urinalysis , stable body weight but loss of bone and muscle mass with occasional scattered fasciculations. He has never had a prostate biopsy or bone scan. Two years ago he developed a circumorbital (around left eye) skin rash clinically diagnosed as Herpes Zoster which faded after two weeks of anti-herpetic pills. What are your best bets and recommendations? Thanks for any help, JE YYYY@YYYY