I think my DH's was 5.1 and they requested a biopsy. Do the biopsy, Regardless of your PSI being suspect, the biopsy will reveal. DH had cancer in like 7 of 9 samples taken. Because of his heart condition, it was suggested by one doctor to "wait and see." That is a death sentence. A friend did that and 10 years later he had bone cancer and even after aggressive treatment at that point, he did not survive. Since my DH could not have surgery, we went to MD Anderson in Houston (we fulltimed so it wasn't inconvenient), and he had proton beam radiation treatment. At 10 years, his PSA was starting to rise by .1 every six months. They told him if it went up more, he would have to come back for scans. Sadly he died from other problems before that had to be addressed, but he did live cancer free for those 10 years after treatment. He was 60 when diagnosed.
My BIL was just diagnosed via biopsy. He is going to have surgery.
Dale