My suggestion would be, if you have kept track of your PSA over many years, then you have historical data that can help you see how it has trended over time. Has it kept steady and this one is an abnormality? Has it been trending up over time? I'd suggest a repeat PSA in a month or two. The proper way to go forward with testing beyond PSA is next and MRI. Standard systematic 12 core biopsies are largely random samples of tissue from the prostate, sort of taken from zones. Chances are great that those 12 cores can miss a tumor. You want the MRI first so if something shows up on the images, the urologist can now "target" that area during biopsy. Slow down in order to be right. It is critically important that you be treated for all of these procedures by highly experienced doctors and centers of excellence. If you can't find that where you are, it's to your advantage to seek it out and travel to where you can receive it. There are also additional tests 4K Score for one that can shed more light on the probability you have prostate cancer. You could also ask for a PSE test, something that is just out on the market. The PSE test as I understand it increases the accuracy of predicting prostate cancer to 90 percent when combined with a PSA test. https://www.news-medical.net/news/20230208/New-blood-test-can-detect-prostate-cancer-with-greater-accuracy-than-current-methods.aspx