David, my PSA had been increasing for several years and my PCP sent me to a urologist. It turns out that because I had been taking medication to help reduce the number of night "pee" trips, my actual PSA was double (9) the number that was indicated by yearly lab tests.
A biopsy was quickly performed which when reviewed by a pathologist indicated 6 out of 12 cores contained cancer , four of which were 4+3 with the remaining two 3 + 3.
Consulted with a urologist and radiologist both of which indicated ADT was required. In the meantime, I had an MRI to look for any spread and had a 2nd pathologist from John's Hopkins perform a review of the cores which confirmed the findings of the first pathologist,
I had to wait several weeks to have a PSMA pet scan to look for spread and it confirmed there was none outside of the prostate. Your research has probably made you aware that a PSMA pet scan is significantly more effective than an MRI in finding cancer outside the prostate .