Do i need a prostate biopsy if my psa is 2.4 and i am 65 yr old?

No: This psa level is normal. 0 to 4 is normal. If however your last psa was much lower a year ago such as 1.2 as an example then one may want to get a free psa to guide if you need a biopsy. If it was about about 2 a year ago keep watching and repeat in a year. An rectal exam is positive for hardness or nodule you need biopsy no matter the psa.

Depends: Psa needs to be viewed as a dynamic test instead of a static measure to determine if a man requires prostate biopsy. Evaluating the trend or change of psa over a period of time is likely a better way to determine need for biopsy.

No Unless: Normally biopsy is not recommended below 4.0 unless your psa rose by more than 0.5 per six months.

Maybe: If you haven't already had one, you definitely need a good exam of your prostate, called a "digital rectal exam". This means your doctor feels the surface of your prostate gland with his or her finger inserted into your rectum. Any enlargement or nodules on your prostate gland would favor biopsy. This simple exam is often skipped due to embarrassment of the doctor or the patient. Ask for it!

Likely not.: Depending of what the urologist felt ( or a transrectal prostate ultrasound shows ) when he/she did the dre digital rectal exam to palpate the prostate. Some nodules may be cancerous. There is a small % of people with normal psa that still may have cancer. In general 2.4 is low for pts that have had no previous cancer of the prostate and most likely requires no biopsy.