Understanding PSA spike and what questions to ask

I got PSA tests about every year since my 30s. Ive never encountered these random spikes. When mine started exponentially rising i suspected only cancer and i was correct.
When cells start dividing rapidly your PSA will go up very fast.
I think with an expanding prostate volume over time with BPH, i would think the PSA would drift upward over the years if it was going to. Look into it.
Im not trying to scare you, but trying to make you aware that there is such misinformation out there that it could guide you off course for many months or even years.

I would echo @survivor 5280 and get the PSE test. You’ll know with 94% accuracy if you have cancer or not.
Not to muddy the waters even more, some PCa’s don’t abide by a linear PSA test, meaning that lower values do not always indicate the aggressiveness of the disease. Right now PSA testing is the gold standard but it is still inadequate compared to many of these newer tests which look for more than one cancer kallekrein (antigen). Best,
Phil

My urologist mentioned that my PSA scores--which rose incrementally over a few years to the last one at 7.67--may have been partially due to a large prostate. Mine is 103 cc. Then I had an MRI which showed a small lesion and a biopsy followed. 2 samples had cancer cells--3+3 and 4+3 Gleason. Now on active surveillance. Also have had BHP for several years. I'm 78 btw and in good health otherwise.

@rcroane56 PSA alone is NOT an indicator you have cancer , nor is a DRE Test , or an MRI . Only a Biopsy can confirm cancer . You rise in PSA can be contributed to by several factors , BPH related , Infection etc .
My recommended next stept would be to request an MRI , in fact insist on an MRI . This will show any liasons and indicate a PI-RADS Score to determine the risk of finding cancer on a Biopsy . RADS 1 , 2 & 3 indicate a low probability where RADS 4 is High Risk and RADS 5 Very High Risk .
Your MRI should be on a Telsa 3.0 machine NOT the older model Telsa 1.5 machine . Additionally , if you require a Biopsy . Go for the latest , widely used , Transperineal MRI Fusion Biopsy NOT the outdated TRANSRECTAL , where you have a higher risk of infection , which may include sepsis . Transperineal has the additional advantage of getting to areas of the prostate Transrectal cannot or at least are very difficult to get at .
NOTE : If you evver get a Biopsy , Request a 2nd or even a 3rd opinion of your Gleason Score as determined by your Biology , pathology results . Recommended by top Urologists and Dr. Patrick Walsh -- SEE BELOW .
Being new to Prostate Terminologies , Gleason Score , PSA Doubling Time , etc. etc . May I suggest the following next steps . 1.0 Purchase the highly respected , and recommended by many on this forum , Dr. Patrick Walsh's book " Guide to Surviving Prostate Cancer -- Study from front to back , where it will educate you to be your own best advocate for your prostate health . You will understand the test procedures , what the results mean , next steps , Treatment options Radiation , Surgery , and Focal Therapy options - the pros & cons ( short term and long term side effects ) 2.0 Watch Dr Mark Scholz U Tube videos on Prostate Cancer . 3.0 Join other forums similar to this one to gget other opinions .
Prostate Cancer is not a death sentence . If you are going to get cancer . This is the one to get - it is the most curable . Don't panic and make a sudden knee jerk treatment decision which you may regret the rest of your life . You will not die tomorrow , you probably had cancer ( if confirmed by Biopsy ) for 10 years or more . It is slow growing . Millions of patients worldwide , are diagnosed with Low Grade Gleason 3+ 3 = 6 cancer and are put on Active Surveillance , ie. Regular PSA , every 3 months , DRE Exam , Bone & CT Scan to check for metastasis and an MRI after 12 to 18 months .If prior tests suggest a change - A 2nd Biopsy .
It's not uncommon to stay on AS and never have any treatment . Steep yourself in Prostate Cancer self education . By contacting fellow Cancer Travellers on this site -- You are on your way .
Good luck and rember James Dean quote : Live life like you are going to live forever .
Live today , like you are going to die tomorrow .