I had proton radiation in 2010 and over the years, I have somewhat elevated PSA. Having completed MRI and a PET scan March 2025 with nothing evident; the consensus includes an issue with BPH. The prostate gland seems to have issues of some sort as part of the aging process. Of course, the best evidence is a biopsy. From comments on this site from many others, urologists come in different "flavors" and as such, one should obtain a second or even third opinion prior to making any definitive decision. One can surmise from reading comments that many men undertake a wide range of medications and procedures.