At 81, high PSA: I don't think I want a prostate biopsy

So we can say definitively and conclusively that his metastatic prostate cancer was NOT CAUSED BY A BIOPSY!!!

Im 79. Excellent health. Had a PSA, 88, on Medicare Annual and was referred to Urologist. The Urologist ordered an MRI. Results: PI-RADS 3, Wedge shaped signal 5mm along posterior, midline peripheral zone, could reflect prostatitis or low grade neoplasm, Density.212. Urologist ordered ISO PSA which came at 8, PSA was 10. Wants Guided biopsy ASAP. He eventually conceded to my wishes of a ISO PSA retest in 5 months - results now pending. Really don't want a biopsy at all. Is there any other option?

I did not want one either. I was only 59. The day before I sat with friends watching a Notre Dame basketball game. The whole time I was whistling in the dark. The next day my wife held my hand and knelt down next to the exam room table. Honestly, it was not that bad. I had transrectal with no complications.

@14810eshimmering
You could get a PSE test, which could give you a 94% accurate reading of whether or not you need a biopsy.

I actually wouldn’t even think twice about having a biopsy at this point. The readings you are seeing point to a problem. It is not infrequent that the cancer is in a spot that is not showing up in the MRI as a lesion, Happens a lot.

I’ve had three biopsies, No big deal. Drove home after and really didn’t feel much of anything. You could make sure you get a transperineal biopsy instead of a transrectal which has less chance of infection, But the chance is very low either way. They can put you under for the biopsy.

@14810eshimmering, the only really great thing about a biopsy is that it can save you from a lot of other situations that you really don't want. 70 to 75 % of cancers develop from this zone. It is also the main area where cancers escape the prostate with the capability of metastasis.
You really have the opportunity to catch this early and preserve important physical functions.
I'd bet you good money that there isn't a man alive who would want to have a prostate biopsy.
I hope you decide to have the biopsy and respond furiously (to me) that you didn't need it at all.

@gently Just took a second ISO PSA test and awaiting results. I will use this second marker to make my decision. If score is same or higher - biopsy. If it goes down - active surveillance. I’m 80 yrs old and refuse to die with a limp dick or pissing in my pants. At my age many friends are living 10 years without treating it.