I’m so sorry you’re going through this – getting a PSA thats high can be incredibly stressful.
As worrying as it sounds, most of the time there are actually many many reasons PSA can spike. I can relate to how exhausting it is to be repeatedly tested and waiting on answers. I went through the same cycle with the NHS and eventually tried one of the newer private blood tests. I got the EpiSwitch PSE which has been all over the newspapers recently, which is like a very accurate PSA with extra things they look at in blood. Much more precise, and while it comes at a little bit of a cost, I found the peace of mind was worth it, especially in helping me decide whether a biopsy was needed. I did end up needing one, and while it was nerve-wracking, my cancer turned out to be a slow-growing type, which was a relief. Perhaps this may have spared you the biopsy, at least for some time.
Hang in there. — Tom