Welcome to HCM.
I do agree with Dr Aditya on the line of approach.
If the PSA is this high, the next step would be to do a prostate biopsy
If the result comes out as cancer, treatment options will be discussed regarding medical vs. surgical treatment
If the result is not cancerous, repeat PSA is needed and if still high, biopsy may need to be repeated.
PSA of 36 means that the disease has spread beyond the organ and the lymph
nodes may mean spread of the disease.
Pls consult a urologist
asap for further action.
Wishing him good health.