If caught early enough, just get the prostate removed. That is the most sure way. Been there done that, cancer free now for over 2 years.
Congratulations. Going on 3 years myself. HDR radiation for me. PSA nearly zero.
My friend from high school did that. He said you never pass a bathroom without using it.
Some folks find the prostate rather useful, and I'd highly recommend getting a second opinion before removing this organ.
Recent advances in imaging move the needle biopsy further down the list of next steps after getting a high PSA result.
Get an MRI w/contrast of the prostate to identify and quantify suspicious areas, before proceeding to biopsy. At least this way the urologist will know where to poke you.
Most prostate cancers are slow growing and will NOT be the cause of death in the majority of men who have them. Provided there is careful monitoring and life style changes made you can live a vigorous life without radical surgery.
Finally, there is a growing acknowledgment that PSA tests may not be the best tool for detecting prostate cancer. There are multiple ways the PSA test can be impacted...anything from having sex to riding a bicycle can raise PSA levels. As men age their prostate often enlarges which also can make PSA levels rise.