PSA of 26: Can fever or illness affect PSA numbers?

rice Acute infection can raise PSA. But without regard to cause, with attention to rise in PSA you should be seen by an oncologist, not a surgical oncologist, nor a urologist. There may be good reason for your urologist to want to operate, but the reason is unclear to me. Focal treatment or different modalities of radiation might be choices for you. It would be good to get an idea of options even if they are after a future of more watchful waiting.
You might find an oncologist (by looking online or asking here on Mayo connect) and ask for a referral. An oncologist would be able to order a PSMA /PET.

I think that jumping to surgery is too big of a step and I would consider a second PSA test and then an MRI and then a biopsy to get a better picture of your cancer. I would also question why your urologist would be so fast to recommend surgery ( they may have a good reason for that ). A second opinion from another urologist ( who is associated with an excellent medical group ) might be in order. Good Luck. We have all been at some stage of the medical journey that you are on.

rice: I agree with hbp and gently. Doctors have their own natural biases and it is worth getting second and third opinions. When you have gathered your opinions, which can be done remotely as well, move as fast as possible to get "it" done. Infections, sex, bicycle riding... can affect PSA. PSMA pet scan was a good next step suggestion.