Although there are many similarities between individuals that have PCa, everyone is different. Determining an individual's risk of how severe PCa is based upon PSA values or other indicators is really just a statistical indicator created from past studies and historical experience. Any one individual can fall outside the highest odds situation.
Based upon my personal experience, one needs to cross their own bridges when they get to them. In other words, since you have the initial indicators that you MAY have PCa, your next bridge is to get the biopsy. The results of the biopsy will give you another bridge to cross.
Each step of the way provides you the information you need to get to the next step.
The initial indicator that triggered my biopsy was an abnormal DRE. The biopsy revealed PCa and thus my next step was to choose a treatment.
Since having da Vinci RP, my pathology report revealed pT3b stage. But since I am only 3 weeks out from surgery I am unsure of what my next bridge may be (if any). I will cross it when I get to it. Meanwhile I will get the information I need to see if there are any more bridges in my future.
It is true that the statistical information that assesses the odds of a certain level of risk is interesting, but it is only a part of the information you need to proceed down your individual path.
Age 58; da Vinci prostatectomy on 1/26/2011
PSA History: 10/2005 = 1.7; 10/2007 = 2.8; 10/2009 = 3.6; 10/2010 = 4.9
Abnormal DRE in 2009; Increasingly abnormal DRE in 2010
Biopsy on 11/23/2010: GS = 3+4 (right side) with 4 of 6 cores positive @ 40%.
Post-OP pathology: GS=3+4; tumor = 35%; pT3b; R. seminal vesicle invasion; Extraprostatic extension into the R. bladder neck; margins uninvolved