Do you have BPH increasing the size of prostate? If no cancer seen and rising PSA I would look at the sizes on all the imaging over the years, if the size increased that means the PSA increases could be from that and in that case PSA rise = BPH. If no change in sizes on imaging (which can be not very accurate sometimes), then PSA is more likely cancer related or other things raise PSA too, from bike riding, to sex, to supplements especially ones with biotin in them. Just an idea to investigate if not done already, not sure, but hope you get to the right answers and anything needed is taken care of.