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As you know, this high PSA may be related to the prostate cancer (but prostatitis and benign prostate hyperplasia can also rise it). So urologist would do following;
1) A digital rectal examination (DRE); physical examination of the prostate
2) Trans rectal ultrasound (TRUS)
3) A prostate biopsy.
PSA alone is not the accurate tool.
A biopsy is the only confirmative test to tell about the non cancerous or cancerous prostate. If it comes out to be cancerous, a Gleason score is calculated which determines the prognosis. Prostate cancer usually has a very good prognosis.
Read about the Gleason score;
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
PSA 35 is not extremely high and can occur due to prostatitis (prostate infection). Prostatitis can be confirmed by prostate examination (DRE); as it shows tenderness. A biopsy is required for the other condition with high PSA. All the investigations can be done at a clinic.
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