Mine was 59 at dx. My GP called me immediately and said that over 40 PSA it is neary 100% sure to involve cancer. He did not say this to alarm me, but to show the importance of getting the Urologist opinion. In fact the GP already had secured an appointment with an urologist that only does prostate work for the next week. The DRE was clear with a nodule and I had the biopsy within a couple of days. When the results were explained, the uro said it was no surprise as he has never seen PSA over 50 that wasnt' positive. My own research prepared me for the dx. He explaineed this right up front as he is very matter of fact, but always very positive, proactive, and never an alarmist.
With a PSA of 50 don't despair, but be prepared that there is a very high probability that it is cancer. In fact if the biopsy is negative, I would have further investigation like a saturation biopsy or color doppler ultrasound to confirm. You don't want a situation where your have advancing cancer that is hiding from the biopsy. Another member had a dozen or more negative biopsies while his PSA advanced to 40, which clearly indicated PCa. His tumor was impossible to find in a standard biopsy and different methods had to be used for dx.
Now is the time to dig into research so that you know the questions to ask as you meet the doctors.