For what it is worth, this is my story of what happened after an increase in my prostate-specific antigen (PSA) that turned up during an annual physical exam.
The urologist I was referred to first put me on antibiotics for a period of time, then another PSA test. The number was higher still, so the next step was an ultrasound, then a biopsy.
After the presence of prostate cancer was confirmed by the biopsy, the urologist provided me with a list of options; since I was relatively young (62) and in good health, with a Gleason score between 6 and 7, I was a candidate for any and all of the treatment options.
After considering the situation, I decided that I would go with radiation therapy; if further PSA tests indicated that the radiation had not been successful, there was always surgery as backup. When I told the doctor this, he explained to me the flaw in my plan. It seems that after the radiation therapy has been completed, the PSA tests are not to be trusted for at least 12 months. So, it would be well over a year before we would know if surgery would be required despite the radiation therapy.
(The radiation is applied in such a way as to destroy the cancerous cells, but the radiation also does bad things to the otherwise healthy cells that make up the prostate, not to mention the surrounding tissues. In response, these healthy prostate cells become inflamed and the PSA score will increase for a period of time. It is necessary for everything to heal and stabilize before the PSA test results become trustworthy.)
So, to make a long story short, I elected for immediate surgery using the da Vinci technique 2-1/2 years ago. Since the incisions healed, I have been returning to the urologist who did the surgery every 6 months for a follow-up. So far my PSA levels have been nearly undetectable, and this makes the doctor very happy; and when he tells me we have reason to be very happy, then I am very happy.