Welcome to a great forum! I'm glad you explained your condition so well and am sorry you have to go through this. We're not professional cancer specialists in this forum, but we're here to help and discuss and to make you feel "at home."
From my recollection, your PSA is borderline for your age, but not alarming. I am 54 and when I called my urologist's office with my PSA results of 4.3 received from my family doctor, the nurses at the urologist were not alarmed at first. When they looked at my charts and saw that my PSA had jumped from 1.2 to 4.3 in a few months, they scheduled an appointment. After an inconclusive DRE and some deep thought, my urologist decided to schedule a biopsy and we found some cancer. Your change from 3.9 to 4.5 does not sound like a large "jump" to me.
You have been very wise about your approach, in getting second opinions and another biopsy. Jan 2008 for the next biopsy is only four months away and I don't think you are in any danger from waiting. For example, my urologist/surgeon said I could wait 4-6 months to do my surgery after cancer was positively identified and she wasn't worried about it spreading during the wait.
Please hang in here with us. We'd like to follow your journey with you and you may be of help to others that join the forum with your similar diagnosis.
All the best,
Barry (a.k.a. Idaho)
Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3 Gleason 3+3=6 T2a Confined to Prostate
Waiting to take that first post-op PSA
My awareness web site: http://pca-info.blogspot.com