Thank you all for being so kind to reply. This PSA number has floored me. Going from stable 1.8 for 4 years to 19.1 in six months has me obviously thinking the worst.
I have an appointment tomorrow with the doctor's Physician Assistant, best they could give me.
I am trying to figure out what to ask during the appointment. To me, I want to know if the doctors have experience with seeing this kind of a spike (10X over 6 months), and is it aggressive cancer normally behaving this way or asymptomatic prostatitis. From what I have read it is doubtful it is due to an enlarged prostate, which I do have but not big enough to produce this level, I think.
Also, I kind of feel they will want to go straight to a biopsy. But should I insist on an MRI first. At this point I am concerned about an explosive cancer that has gone beyond the prostate.