I think the next step is a deep breath. Take the win for now....get on with life. (that may sound a bit glib, but, I realize having been there, how hard this can be to do)

5.3 is a little elevated of course, how elevated would depend somewhat on your age. There are things that can have an effect on this test, sexual activity, exercise and cycling to name a few. The 4 PRADS rating is concerning, but, it means it's time to get the biopsy, it's based on a percentage it's not 100%, if it was a definitive thing, you wouldn't need a biopsy. It sounds like you have gotten the best biopsy out there and it was pretty comprehensive. If the tests got the lesions themselves, you might be okay.

I hadn't heard of the Confirm MDX test, didn't need to since my original biopsy showed cancer. However, it sounds like you and your team are doing your due diligence for sure.

This type of cancer, particularly in the very early stages is normally very slow going. A 6 week PSA won't hurt but it might not tell you much either. You will also get the other test back inside of 6 weeks, if that's negative, why bother? Knowing what little I know now, I might ask for a three month PSA to add to the 6 month already planned. If the Confirm MDX test comes back negative, I don't think I'd bother. Other than that? I'd keep busy and try keep it off my mind as much as I could. Sounds like you've done all you can.

Also maybe keep in mind, IF the legions are part of a BPH, which is possible it appears, that also can elevate your PSA some.

I don't know anything about medicare, not on it yet.

Best of luck to you !