Checking in a year later. To recap, last year at my annual, at the age of 55 my PSA went from 1.1 the year before to 2.5 and I posted asking some questions. My PCP ordered a retest, and a couple weeks later it was 2.2. Both he and my urologist felt that this was an ok value and could just be my new baseline as I age. I have about 15 years of PSA values now, and for the first 13 it was between 0.7 and 1.3 - mostly at or below 1.0. The last 7 were solidly in the 1 to 1.1 range. I have been being treated for BPH for at least 12 of those years, so BPH is not causing a rise. Then last year it jumped to 2.5/2.2 in the two readings. This year at my annual it was 4.9. Retest took it to 5.0. %Free PSA value of 12. After retest PCP ordered a urology consult. Went to see a new urologist. (Mostly because I wanted to have the urologist in the same system as my PCP.) Got lucky because somebody must have cancelled at the this urologist and I got in to see him in 2 days. His next appointment was 3 weeks from now. Saw him yesterday and he said the number alone isn't necessarily concerning, but given the rise over two years, it was a possible cause for concern. He said we could track it for the next 6 to 12 months or we could do further testing. Upon DRE he said my prostate was not overly big, but that there was more firmness on one side than the other. He felt there was enough indication to do a biopsy. He also said he did not suspect prostatitis because it was likely that the PSA number would be much higher, plus I wasn't exhibiting other signs of prostatitis. He did ask if I would lose sleep if we continue to monitor, and I said so far I have not, but given the rise from 1.1 to 2.5 to 5 over 2 years, if I have to go another year, and take a test every few months to monitor, I probably would be stressed and lose sleep. So he ordered a TRUS guided prostate biopsy. My assumption of a TRUS guided prostate biopsy is that it will be needle entry for samples through the transperineal region, guided by the TRUS. But I guess I should confirm that, and that it is not a TRUS with needle attached to US probe. The procedure will be 2 weeks from yesterday, so I guess I am about 4 more weeks from a possible answer. I realize biopsies are not always 100% accurate (if they miss a cancerous spot), but it is better than a blood test only and waiting.