-PSA is a crappy diagnostic tool regarding prostate cancer. PSA with Free PSA percent gives a somewhat better assessment of cancer risk.
-Biopsy is a shot in the dark. If they find cancer, they scored, but if they don't, it actually means nothing. Without MRI guidance, the pattern of needles is random and can completely miss cancer in the prostate. So if PSA stays up, what do they want to do? ...More biopsies.
-I am in somewhat the same boat as you, PSA is higher than desired, but my PSA is not on a steady rise. I am not going to submit to biopsy as next step. Look into 4K score and 3T multi parametric MRI. Also seasrch for Orrin Israel's posts about this on this forum.
-Hopefully there will be better blood tests coming soon.
Dr Rand McClain referred to an Oncoblot test, but it is not currently available. I really hope something like it that is truly definitive becomes available.
-Testosterone remains highly controversial in relation to prostate, but The old addage "taking testosterone is like throwing gasoline on the fire" referring to prostate problems has been pretty thoroughly debunked. Many Uros don't even know this, just like most don't know how to manage TRT.
-Most prostate cancers are indolent-slow growing and do not kill the patient. Patients die with, not from prostate cancer, and taking testosterone has VERY little to do with progression of this type of prostate cancer
-Aggressive metastasizing prostate cancer is a different beast, is not commonly cured by surgery, radiation seeds, chemo, androgen deprivation etc. despite what the industry would like you to believe. This is because if it is this type of cancer, the Prostate cancer cells have already spread by the time of treatment. This is documented in the references of Dr Bob Leibowitz's videos below. Success rates are in many cases determined by remission, not cure. These techniques often work well to put things in temporary remission for 18-20 months, then commonly come roaring back. Some multi drug approaches seem to work better at "turning (metastasizing) prostate cancer into a chronic illness that is treatable, but not curable", though hormone blockade. androgen deprivation therapy is part of the treatment... sounds miserable.