I would recommend going to a center of excellence (such as Mayo-Rochester). Rural doctors just don't have the experience that is needed. Before I retired, I went to my local doctor (Davenport, IA) every year to have a physical. One of the tests they performed was PSA level. I was busy traveling for my job, so believed what they told me (everything looks good with your tests, good to go). After retiring, I wanted to more closely manage my health. Went to a cardiovascular team to change my diet so I could get off the statin I had been taking for a decade. The nurse practitioner was a friend of our, so she reviewed my entire medical file. At the end of my first meeting, she asked me if I was addressing my prostate problem. I asked, what prostate problem. She let me know that my PSA had been rising for over 6 years, doubling three time, with an increasing velocity. At that point, I went to Mayo-Rochester, was diagnosed with PC (Gleason 7-4/3). Being 56, I went with a radical prostatectomy and doing well now (10 months later).

Bottom line, these mid-sized practice doctors cannot be trusted. You must do your own research, manage your own health, and get to a center of excellence when there is a problem.

Best of luck,

Jim