High PSA and worried

Your Urologist will likely recommend an MRI and maybe a biopsy. But don't let that scare you.

Understand that prostate cancer (PCa) is generally slow-growing -- especially low-grade & favorable intermediate-grade PCa.

That is, you probably have time (maybe a lot of time) to research your options.

My Suggestions:

1. Talk with your Urologist about tests he recommends.

2. Don't rush to biopsy -- decide AFTER getting a multiparametric MRI, preferably from a Center of Excellence.

3. Before getting a biopsy, consider getting a PSMA PET/CT body scan. You're injected with a radioactive dye that identifies PCa. (An example is the brightly-lit middle image below.) PSMA PET scan is especially useful identifying PCa sites if you have spread outside the prostate.

4. Old-school biopsies randomly sample areas of the prostate and can miss tumors, especially early-stage small tumors. Instead, get a targeted biopsy (aka MRI-Ultrasound Fusion biopsy), which combines (fuses) your mpMRI with real-time ultrasound images. This allows your Urologist to target your biopsies to areas-of-interest in your prostate. Other areas in the prostate can be randomly sampled as well.

5. Research, research, research. Early on, I found this video helpful:

Based on what happened to me, I think it is very important to get a second opinion by some-one not related in any way to the first doctor. The urologist that diagnosed me and then did the robotic surgery came across as a know it all. After the surgery (June 2022) I never went back to him. Then a couple of months ago my primary care physician (who I see only 4 times a year) told me that some tests that I had taken showed that I had cancer in my lymph nodes. This enraged me. I had always been a sexual adventurer, but without my prostate I can't get an erection. I can't achieve an orgasm no matter what I try. I'm 70 years old and I had decided that if I had to give up sex in order to save my life - well I was willing to make that trade off. But to find out the prostate cancer has spread to my lymph nodes makes me furious. I gave up drinking alcohol in 2019 after going into liver failure. I still miss it. I gave up sex 2 years ago, and damn it! I still most assuredly miss that!
How many things can a guy give up before coming to the conclusion that perhaps life is no longer worth living? Truthfully if I did not have 5 rescue cats to care for I'm not certain I'd want to stick around.
But I do have some responsibilities and so I am scheduled for a PET Scan next week. I don't know enough to select either radiation or chemotherapy if it comes to that. But I am certainly not simply following what the urologist who talked me into having prostate cancer surgery says I should do.
Good luck to you.

As I said in my initial post, my PSA number was 12.2 two weeks ago. I was told to get a retest yesterday. I did and it now reads 9.6. I'm not sure what that means. I like the trajectory but I think I should still do a follow-up.

I just turned 70 last October, at my annual physical & blood tests, my PSA had jumped from 4.47 6 months earlier to 6.62 so my Primary Care Doc referred me to Urologist who ordered MRI and 4K score test. Multi parametric MRI showed 12mm lesion and PIRADS 4, the blood test marker 4K score was maximum at 95 I am scheduled in a week at Mayo for Fusion perineal needle biopsy. Prostate size was 50 cc and I've had BPH symptoms for last 4-5 years, also ED for the last 10 years, but Viagra worked until the last 6 months, now take 2 blue pills and it's barely enough. I found out that 5mg Cialis actually is prescribed for BPH & ED been on a week, it has definitely helped the BPH, haven't tried for ED but just doesn't seem powerful enough. I too quit drinking 2 years ago, no drugs, not even a cigar, so I know the feeling about giving up all the things we love. I have been overweight for 20 years and it is contributing to my ED, as well as a factor in PCa, so now will have to give up enjoyable food. I told the Urologist at Mayo, I'm not interested in surgery or radical radiation that has a chance of taking away what little potency I have left. The bible say we should live to 3 score & 10 so 70 years old, I have got my time in. Hopefully the biopsy will be 3+3=6 Gleason so Active surveillance will be the plan. My Dad had PC and RP at 64 back in 1984 left him impotent for the rest of his life, the PC had escaped during surgery, but with drugs from Mayo, he lived to age 90 when it finally went into the bone. He lost his wife ( my Mom) at 82, he was always in a good mood, played golf until 87, so there is life after sex.