A friend of mine had PSA numbers that would rise then fall and they didn't find PC in him until 3 biopsies later. I have a history of high and fluctuating PSA numbers since age 42 which started this mess. I went from 4.5 to 3.18 to 4.04 to 2.48 to 3.44 and finally to 3.58 6 months later. PIRADS 3 and PIRADS 4 lesions and Atypical cells suspicious for cancer but no definitive findings. I have been on active surveillance for the last 6 months. PSA numbers can be all over the place.