@mtsenior You don't mention whether you've had an MRI. I believe MRI is generally regarded as superior to PSMA PET for detecting cancer within the prostate. My urologist used the MRI result to partially guide where to take biopsy cores. PET is the tool for detecting if the cancer has metastasized. I.e. Medicare approves MRI before biopsy, whereas PET is afterwards only if indicated.

When my PSA rose from around 3 to nearly 7 within a bit more than a year, my community urologist ordered an MRI. The result was "highly likely" that "clinically significant" cancer was present. This caused me to accept a biopsy. Since the MRI showed "seminal vesicles involved", the urologist, when he did the biopsy, took several cores from my seminal vesicles.

The seminal vesicle cores contained cancer. Because of this, my case was staged as cT3b, i.e. "high risk", meaning the docs will tend to throw everything in their toolbox at it. Without the seminal vesicle involvement, given the rest of the data available, i.e. PSA below 10 and nothing palpable on DRE, my case would have been staged as "intermediate", either favorable or unfavorable. The treatment proposals compared to "high risk", and the long term outcomes, are quite different.

All the tests leading to a diagnosis are not perfect, even though most people, docs included, use words when they talk about the results that seem definite.

Anyway, if you haven't had an MRI, ask your doc why not.