Increasing PSA numbers, biopsy scheduled: So many questions

Both Rochester and Phoenix have Proton Radiation Treatment. Jacksonville Mayo does not. Limited research on proton versus photon but proton limits additional exposure to radiation damage to surrounding tissues and organs. There is little to no exit radiation beyond prostrate.

You are fortunate to be in Phoenix Mayo as they do have proton there. My advice is to do a lot of research with a lot of sources. NIH, American Cancer Society, Clevland Clinic, Mayo, John Hopkins, WED MD. You will get a lot of information and better understand the options and pros and cons of each. It is important to be a informed patient and don't be afraid to asked question and get second opinions.

There are a lot of reasons that your PSA could go up, not just cancer. Not all MRI's are the same. I believe that the Multi-planner MRI is the best, along with the PSMA. I did some research and ended up having a perineal prostate biopsy by an oncologist who was the department head. The results of the procedure itself were great. No pain, no bleeding no problem. I've heard horror stories from friends who didn't go my route.

Thank you for this advice. Unfortunately my husband plans to go through with his current biopsy (rectal) because he is too anxious about delaying the procedure while he finds another doctor willing to do the perineum approach. He lost his mom 3 years ago in a matter of a few weeks from a very aggressive form of cancer so his anxiety level is unfortunately quite high. We will have to say lots of prayers that things go well. Once the biopsy is complete, then we do plan on switching his care over to Mayo, regardless of the outcome of the biopsy, for either continued observation or treatment if cancer is found. Thank you so much for your guidance.

I had no problems with the fusion guided trans rectal biopsy.
Good luck to your husband.