Hi, I just joined this forum. I am age 66. I have been monitoring my prostate since 2004 when PSA went over 4. It is presently 23--has never doubled. I have been following alternative methods so far--diet, exercise, and just started CBD Hemp oil. I also follow an alternative prostate group on Hope-list of yahoo groups--Holistic Prostate Group.
i just read about CAPRA, CAPRA-S, Decipher, Prolaris, OncoType-
three tissue based tests looking at prostate cancer genomics. The discussion was working on reducing the over treatment of men with lower risk prostate cancer. This came from regular email of the www.prostateforum.com
One of today’s leading prostate cancer doctors (and PCa survivor) tackles the most compelling issues in the prostate cancer field today for patients.

Let me know....I still have not had a biopsy yet, still holding off--and the tests i have done--color doppler sonogram-shows the lesion--has low blood flow to it, and MRI, and the new test at U of Michigan lab(MIPs) all point towards high risk than low risk-and strongly direct me to have biopsy so can get Gleason score, and look at number of cores. Then the genomics tests use tests done from biopsy. And of course the projections say that if PSA over 20 is high risk-my last was 23. I just set my next checkup for end of August at Scholz. I am planning to move to Thailand this fall for a while--to check it out.

I would have a biopsy as well. It isnt one of life's more pleasant experiences but it will help you and your MD decide first of all are you positive for cancer (yes it can come back negative and then you will potentially face repeat biopsies), but with a PSA of 23 your URO will really want you to have it. In any case when you get the result and if its positive then you get a Gleason score which is a key determinant of treatment. On a slightly different note a friend of mine moved to Thailand when she and her husband retired and they love it. Best of luck