I had 2 PSA tests given by Kaiser 10.9 and 11: What test is next?

osvtampco, the next test is usually an MRI. We like the MRI later combined with ultrasound for a guided biopsy. LA has the big Kaiser Cancer Center but they don't list prostate. It's hard to imagine that they don't treat prostate. But you should start making some calls.
I don't think you should be talking to a PA. This PA is incorrect.
Message your general practitioner and ask them to order an MRI with and without contrast. And then schedule it on a 3Tesla.
You already know from the reading that a rise in PSA can be caused by things other than cancer. The MRI will tell you if cancer is likely or unlikely. From there they will determine if you need a biopsy.
It is better down this rabbit hole if cancer is detected early.
It's a bit scary that you had to request the PSA.
Let us know how this progresses. Best luck

Hi thanks for responding ! I hope you will follow up with me as I have a couple of questions about your suggestions . I should clarify that I didn't request the PSA tests , I just scheduled a general check up since I hadn't been to a doctor for many years - my GP scheduled me for a blood test of which PSA was one of the things tested for ( I had no idea what a PSA test was , I was more worried about cholesterol ......) but my GP told me to make an appointment with their urology dept. which I did - and it turned out to be a PA ... I guess she works in the urology department they didn't offer me an option of who I could talk to but she seemed very pro-biopsy and almost bristled at my MRI suggestion .
What is a 3Tesla ? Is it a special type of MRI machine .. You sound pretty sure that if I ask for an MRI with and without contrast scheduled on a 3Tesla that they will do so - I guess it wouldn't hurt to try . Also the PA said that I am entitled to a second opinion . Thanks again for your response and I welcome anymore suggestions you may have .

ovt, as long as you're going down the rabbit hole you might as well start your education on your prostrate. Read a bunch of threads and responses on this site. It will lead to more reading. Dr Waltz has books and Dr Sholtz on youtube has many videos to watch for starters. Knowledge is king. Your urologist will recommend surgery if anything is amiss. But remember there are many more modern options to choose from and it's YOUR life and health choices that you need to make decisions about. Your test scores may be nothing to worry about.
Do you still work?

Hi , thanks for the response . Yes I'm starting to get educated on the topic there's a lot of material - much of it conflicting - I tend to believe what I want to believe , its hard to get over my biases . I'm going to see if Kaiser will authorize a quality MRI and then follow up with a biopsy . I'm still kinda wishing I didn't take the PSA test but I had no idea it was something that was done in routine blood work . I keep watching the youtube videos there's a ton of them out there to wade through - I don't want to " OD " on prostate info though as it may not be the best thing for my mental health .... , also what are some of the modern options you mentioned ? Just curious and yes I'm still working I'm self employed buying and selling collectables .

An MRI can rule out an unnecessary biopsy. More importantly it can direct the later biopsy in an mri ultrasound fusion biopsy. https://www.pennmedicine.org/for-patients-and-visitors/find-a-program-or-service/urology/male-urology-program/mri-fusion-biopsy#:~:text=The%20fusion%20biopsy%20technology%20combines,tissue%20sample)%20with%20a%20needle.https://www.californiaprotons.cutm_source=yext&utm_medium=referral&utm_campaign=local&st-t=yext
Biopsy without MRI has been referred to on this site as blind biopsy.
Your physician may refuse or may be limited in his ablilty by contract with Kaiser.

3 Tesla is the measurement of magnet strenght. 3T can detect tumors of 3-4mm undetectable by the lower strenght 1,5T.

At USC the internist ordered the MRI as soon as he saw the 11 point PSA. I think the MRI is usually ordered by the urologist. It may be that the urology practice this PA is attached to likes to go straight to the biopsy. I don't think you should agree.
You may not even have a lesion. I suspect you haven't had a digital exam. And I don't blame you.

Prepare for the education OF your life, and FOR your life.

Do not, i repeat, do not kick the can down the road!

Best wishes and may God bless you.

osvtampco: I agree with @gently. Get the MRI with a more robust machine, which would be a T3. The fusion biopsy, just paints a stronger image for the doctor to work with while taking a sample of your prostate. I had a twilight drug for the biopsy and I was glad I did. Use your biopsy material to get a Decipher test to check out the aggressiveness. It IS USED by doctors to evaluate treatment and they have changed their treatment plan many times because of that test. Keep in mind that doctors and nurses are dedicated, but NOT infallible. They have multiple ->unintentional biases< - that can impact your quality of life because of treatment recommendations. Get second or third opinions where you can.

Take one step and one day at a time and keep coming back here after each step. We all want to help, where we can. Each person here has their own experience with each unnerving and sometimes confusing step and many will have common overlapping suggestions while others, especially when you get into prostate removal or the different types of radiation and associated machines, will leave you in the position of making your best educated guess based on all of our experiences. Your doctors will of course add valuable help but the insight you gain here will really help you move along as comfortably as you can with scary stuff like cancer, as it did for my journey. They helped me make the best decisions that worked for me and my quality of life after treatment.

Hi Gently , thanks for the advice I really appreciate it . I have a couple of questions - you say a high resolution MRI can rule out an unnecessary biopsy - if this is true what would the MRI have to show to make the doctor feel that a biopsy would be unnecessary ? Do you mean if they do an MRI and there are no visible lesions they would be likely to not recommend a biopsy ? If that's true why would they even consider a biopsy first ( considering the chance of side effects from a prostate biopsy ) .
Also , can you explain what a digital exam is ? Sorry I don't have a clue ....
Thanks in advance for any comments .

ivstampo, if you don't have a tumor or if you have a very small tumor, an ultrasound guided biopsy wouldn't find it a very small tumor except by accident. And, yes, the tumor is what they want to biopsy.
A digital exam is a gloved palpation of the prostate through the rectum to feel for hardness or lumps that could be cancerous tumors. The rate of detection from this exam is very low.
I don't think they should consider an US biopsy first because because of the advantage of the MRI/Ultrasound fusion biopsy for choice of sites. And because a biopsy may not advantage you at this time.
You may not have cancer, but you'll want to keep watch for any later developments and you may need the biopsy later.
I wouldn't imply motive in any case. Probably lack of equipment, maybe comfort of old methods, belief in the adequacy of ultrasound biopsy.
The bristling response to your request would make me suspect monetary consideration. A US biopsy is more lucrative than a negative MRI follow-up.

HI , I tried asking GP at Kaiser for a 3Tesla MRI as per everyones suggestion - I said that its a good way to avoid an unnecessary biopsy for possibly insignificant cancer and if not it would help later for targeting the biopsy . This was their exact response : " Please inform patient that an MRI is not appropriate for further evaluation of elevated PSA levels. He can get a second opinion from a Urologist, but he will need a biopsy. "
Anyone have any thoughts on this ? I notice that many of you guys have been able to get MRI's and other types of treatments done did you have to fight for this ...... is it your insurance covering this ? Or do you just write checks ? Do you think that maybe I have the wrong health care company ? In any event if I do decide to find an outside company and get an MRI do you know what the approximate costs are for this with what ever lab work would be required ? Thanks in advance for any input .