There is no maximum PSA that a patient can have. Once a diagnosis is established or treatment initiated, the extent of the PSA could be considered as a marker for the extent of the disease. There are several reasons why you are not a surgical candidate. At age 75, the multiple co-morbidities (heart disease, congestive heart failure) that you have would not make you a surgical candidate. For surgery to be considered as an ideal treatment, the patient typically has a life expectancy of at least 10 years so that the survival advantages that are associated with surgery can be seen. Given your age, and other medical problems, it is not certain that this would apply in your case. However, given the rate of change of PSA, it does appear that you may have a more aggressive form of cancer. The results of the biopsy would be helpful in order to make a recommendation for the best treatment for you. Treatment options that may be beneficial to you potentially include radiation or hormonal therapy.