Hello Cwrkr and welcome:
Here is info on the PHI test from the manufacturer that is fairly easy to read and understand: https://www.beckmancoulter.com/products/immunoassay/phi
Yes, your PHI score indicates a significant risk of finding prostate cancer on biopsy. So it would appear that a biopsy is likely in your future. You can probably forget your PCP as your journey continues as many (most?) of them are too generalized to have a good understanding of the details of our disease. But your uro should have the knowledge and be able to explain what the heck is going on. If he cannot or will not then please find a urologist who will. If you will tell us your geographic
location it is likely that some of our members will be able to recommend someone. And BTW, 4 weeks is WAY to long to wait on test results.
You might want to provide us with a history of your PSA. Prostate cancer generally doesn't present a quick spike in PSA but grows gradually over time. A quick spike is more likely an infection. But with your PHI I still suspect that you will need a biopsy to help you understand what is going on and your options.
Please feel free to ask and and all questions. We are here to help you get through this.