Most large spikes are due to prostate infection/inflammation rather than cancer. Best is to be prescribed and take antibiotic treatment and then get retested in 1 to 2 months. If it is high due to inflammation and this persists the retest just gets you more concerned without eliminating anything. Inflammation can easily triple the PSA. I know people that had PSAs 1.5 jump up over 7 and after antibiotics drop down back under 2. Can also get a free PSA test with the retest (same blood draw). If cancer free PSA is typically 10% or less; no cancer free PSA 25% or more ... and then the gray zone is > 10% and < 25%. This test costs about the same as standard PSA but you need both since it just provides free PSA, not total PSA.

The other item you will need to deal with if the PSA does not go down is who is paying for the MRI, Biopsy, etc. Medical insurance not likely to pay until PSA is over the limit. May get an exception if in a high-risk group (1st degree relatives had prostate cancer, etc.) or have a second large increase with a retest about 6 months later (but then your PSA should be over 3 which is the typical bogie at age 53).