Hi. I'm in a similar place and thought I'd share my experience if it helps. I'm 57. PSA has hovered around 5-7 for a couple of years. Had an MRI a couple of years ago that didn't show anything. Recently had an Iso PSA result of 22.8. Urologist ordered another MRI, which showed a lesion (pirads 4) on the prostate, but nothing outside of it. Had my first fusion biopsy yesterday so will get those results in a week or so. Still passing blood, etc. and a bit groggy -- probably from the anesthesia. Worked from home in the afternoon and back in the office today. (I know a lot of guys are able to go back to normal activities the same day, but I didn't.) I was nervous about the biopsy, but it wasn't as bad as I thought. Now just waiting on results. I also live in a similar city as Indy (St. Louis) with great healthcare, but not necessarily Mayo, etc. I'm happy with the urologist so far, but once I get my biopsy results, I do plan to send all results over to a "Center of Excellence" (Mayo, Cleveland, MD Anderson, etc.) for their opinion, even if my urologist says everything is AOK. This group has been super helpful in helping me educate myself.