Welcome to HW, to be completely on the safest side, I would go for the biopsy, as a general rule, they are unpleasant but not a major pain event (I had 3). At this point, only a prostate biopsy is going to detect PC. We have men here with full blown PC with PSA scores no higher than you mentioned. If there is cancer now, hopefully it would be small, minimal, and contained at this point, and he might be best served by AS as mentioned above. If there's not, then you did all the right thing, and have more than a good baseline if things start to change in the future. You can have a raging case going on, and never have a positive DRE or high PSA, and without the biopsy, there is really no way of knowing for sure. Tough call either way, so you two will have to do you homework as you are doing, and make your own choice.
The free PSA % # is low enough to be suspicios at this point.
Also depends how much of a gambler one is. Best time to catch PC is when it is tiny and contained and can be controled.
Please keep us posted.
David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence: 1 Month ED: Non issue at any point post surgery, no problem post SRT
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped 9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4, Caths #11 and #12 same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days