Hello and welcome Honker,
Zufas above is correct, it's your PSA velocity that gives the concern for the biopsy. If you look at my psa stats, you can see how i ended up here. it still doesn't mean you have cancer, and this 1st biopsy may or may not cancer. if it comes back "clean" and your psa continues to rise over time, you could probably count on another biopsy.
as far as pain with the biopsy, pretty subjective thing. i have 3 done over 15 months. 2 without any thing for pain, and 1 with local pain shots. the shots that administer the pain shots hurt me more and made me come out of my skin then without the pain med. so i told my dr on the 3rd one, give it to me straight. for me, the biopsies are unnatural, degrading and unpleasant, but not a terrible experience.
keep us posted on your situation
david in sc
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, 40 - 90%, G 4+3 & 3+4
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, Catheter out on 12/15/8. Stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08. Emergency room put in Catheter # day 45, 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/13/9 - removed blockage, put in Cath #5, 1/19/9 -out
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grams, tumor 20%, Contained in capsular, clear margins, clear lymph nodes
First PSA Post Surgery Scheduled now for 2/9/9