My PSA has risen constantly from the age of 50 onward, since a couple of more slowly, now sometimes quite a lot above 5, a few times a bit less.
The biopsy isn't a pleasure, but certainly not painful ... with a sedative, like izzy got. And I had to follow a list for taking medicaments, not eating what etc, too. Plus, I also enjoyed the "tv program" during the procedure (which lasted about 5 mins in my urologist's practise).
Generally speaking: the level of the PSA value is not decisive, but whether it rises suddenly and rapidly. (I have also had my PSA checked every three months for years).