Your story sounds a tiny bit similar to mine. At 54 (I'm 55 now), I had a PSA of 8.0 and 2 months later, 11.8. I had an MRI that showed nothing and a TRUS biopsy that showed nothing. I started on Finasteride, and 6 months later, PSA was down to 4.9. One thing about my prostate is that it was close to 200 in volume, so an enormous gland. I have essentially no side effects from any of it. All of my related "scores" seemed within a range that two Urologists weren't terribly alarmed after the MRI and TRUS. I pee normally, normal sexual function (though ejaculate volume and consistency decreased/changed after the TRUS), I only get up to pee at night if I drink too much water right before bed - and then only once, etc. I'll be back in March for the 12-month look. It will be interesting to see how things are shaping up then and the next recommended steps. I have a couple of other health issues (mini-stroke 2 years ago, high BP, Afib 2-3 times the last few years), so I can empathize with thinking through the "getting affairs in order" aspect of it all. I'm hoping that diet, exercise, weight management, mindfulness, and working with my care teams will help me stick around a good long while. I know my amazing wife is hoping I do! I'm 6'7" and weigh 335 (down from 365), and working to get to 275 (recommended weight for my wide frame - most people guess I'm 270 now as I "carry it well"). God knows what I need, and I know He will carry me no matter what happens.

Best wishes for your own journey!