I have been in a similar situation. I turned 71 in May. My PSA has been on a roller coaster for about 5 years. I had a biopsy a number of years ago which was negative. In 2021 I changed urologists and she recommended an MRI, also negative. This winter my PSA went up to 7 and she recommended a biopsy. I got a second opinion and it was recommended I get an MRI first. It came back negative. My urologist noted that the MRI only examines about 80% of the Prostate. After some discussion I had a biopsy in August. I had 14 cores taken and 1 showed cancer, 3+4=7. I’ve met with two different surgeons and both agreed removal was the best option. I have surgery in 3 weeks. Hope this helps. Best wishes!