Top-level: I'd suggest give PSS a try. Start by turning off mod_pagespeed when you do, just to simplify things. That will give you access to a couple of filters that are designed for reverse-proxy situations, exploiting the proximity of the Google PSS servers to your clients. Check out "prioritize visible content" and "flush early".
There are a few reasons why you might wish to use mod_pagespeed at origin, for the exact converse reason. Since mod_pagespeed runs at origin it can load resources directly from the file-system, which means that they are updated instantly in the rewritten pages. If this feature is important to you, it might be worth trying to configure MPS to do cache extension only, before sending the resources to PSS to be optimized. But I have to admit we haven't tested this combination excessively. Let us know how it goes!
I'd suggest *not* letting both PSS & MPS do image optimization. That will just waste CPU time, and if configured differently might attempt to re-optimize the same resource. It would be better to let PSS see the original resource and optimize that.