My husband is 51. First PSA was done in 2005 during a routine physical with a reading of 2.5. Since then, he has noticed decrease in force during urination, decrease in semen during sex and other changes I have attributed to normal aging. During a physical in Jan. 2008 had a DRE with no palpable abnormalilities other than Dr. remarked that he had a large prostate (which had been said by other Dr.s as well in 2005 and in Jan. 2008 during colonoscopy) & PSA of 3. Dr. prescribed antibiotics and retested blood. Results were 3.3. *Between the 2 tests my husband discontinued taking Saw Palmetto, which he has taken for several yearsand we had sex the night before the second test. Since then have read that both could cause an elevation of PSA levels. Now Dr. has ordered a Biopsy. We are hesitant to go right to a biopsy due to all the controversy and are wondering about the new PCA3 test, the free PSA vs total PSA and since his prostate is large, the consideration of PSA density test. Are we micro-managing our Urologist and should we just go ahead with the biopsy or be persistant with requesting more tests?