(Thanks for the later clarification regarding the scheduling of the MRI & biopsy.)

With the average age at diagnosis being 66y, your “middle-age” status is right at the cusp of that curve. (I was 56y when I was initially diagnosed.)

What’s important first is the MRI results, not the biopsy results. Once you get your MRI results you’ll have a good indication of the “probability” of the direction you’ll be heading post-biopsy.

Much of prostate cancer diagnosis and treatment involves waiting. Use that down-time to study, research, and become a “student of prostate cancer” (as I refer to it). If you do, you’ll be better prepared to make an informed decision no matter what the biopsy results are.
(Plus, it’ll keep you busy and not “just sitting around thinking about worst case scenarios.”

As you’re researching this, don’t just “read on the internet.” Instead, read from legitimate medical/hospital sources (like Johns Hopkins, Mayo, and others) as well as reputable organizations (like PCF, PCRI, and others).

As for testosterone, are you tracking that along with your PSA tests? Knowing your testosterone level will be beneficial later.

Lifting weights only creates a very slight increase in testosterone - and that slight increase is only temporary. (Otherwise, top bodybuilders wouldn’t need to take performance enhancers.) Also, weightlifting will be beneficial down the road (but, not for needing “strength for a potential battle with cancer”).

Regarding your family history of cancer. What they’ve found is that there are a few genetic markers that are common to prostate, cancer, ovarian, and some other solid-tumor cancers - and those genes can be passed from either parent to their children. They say that ~15% of prostate cancers have a genetic component, and that if a first-degree relative (parent/sibling) has prostate cancer and they have one of those genes, that it increases the odds of getting prostate cancer by 50%. (See attached chart of those genes.)

Yes, you should get the genetic test while you’re waiting. You may (or may not) have inherited any of those genes. If you can’t get the genetic test from your doctor or your insurance company won’t pay for it, you can get a free prostate cancer genetic test here: https://www.prostatecancerpromise.org/
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Curious as to what your annual PSAs were in the years prior to that November PSA of 5.8?

Are you sure that your “Free PSA” is 10.3? Or is that your “% Free PSA”? (Free PSA is typically lower than Total PSA.)

When the Total PSA is between 4.0-10.0 (the “grey zone,” they call it), % Free PSA is a helpful predictor of prostate cancer and helps decide if a biopsy is needed, with a lower percentage (< 15%) often suggesting a higher risk of prostate cancer.