Hi Artist Mark-
In a man of 59, a PSA of 3.5 is actually pretty high. Some urologists use a cutoff of 2.5 in younger men, up to 4.0 in older men. There are no rules about
it. PSA density (PSA/prostate volume) may be a better indicator if it is > 0.15. Your elevated PSA could be due to a number of causes, like prostate enlargement (BPH) or prostatitis (the firmness sometimes is a clue to that). That alone wouldn't send you to biopsy, but the fact that it's been progressively rising, your low %fPSA, and the lump he felt, all taken together, might. I don't think there's much risk waiting for another PSA - you might ask for a PHI test next time. You have to call the link below to arrange it:PHI test
I agree with you that there are way too many biopsies and there are risks, but when you have to, you have to.