@sharlee
No it does not mean your cancer is back. This does not come from my opinion but my Mayo urologist, and R/OS at Mayo and UFHPTI.

Just like before you had prostate cancer diagnosis many things can make your PSA rise. BPH, irritations, infections, etc.

Regarding cancer. Most radiation treatments are not designed to kill prosate cancer. What is done is it damages the prostate cancer cells and they cannot reproduce. Unlike regular prostate cells when damage they can reproduce. This was explained to me by R/Os at Mayo and UFHPTI. There are some radiation treatments done to actually kill the cells but most radiation treatments are done to damage the cell reproduction ability of prostate cancer.

What has your PSA levels been? Have they been rising every time you get a PSA? How long did it take to get to 2. How ofter where you getting PSA test done?

Looks like you are seeing a urologist and thus asked him your questions. He/she is your best source of answers to your questions as he is familiar with your prior cancer diagnoses and treatment you received. His/her suggestion for a PSMA is good as can detect cancer cells.

A 2 is still below the norm level of PSA (below 4). Are you having any BPH symptoms?

My R/Os at UFHPTI said their goal was to have my PSA below 1. So far I am below that almost 2 years later. However BPH and many other things can cause PSA to rise and many others. Think optimistic.

When you had your radiation done did they radiate all your prostate? Why do I asked? My R/Os stated to me they radiation all the prostate and margins not just the areas identified by biopsies. Why? Because almost impossible to do a biopsy of all prostate tissues. Thus you urologist doing biospsied could miss areas that have prostate cancer cells. It is normal to do margin for this reason also.

Even if you have a RP surgery does not mean there were not prostate cancer cells in other areas. It is that PSA number that rises steadily that needs addressing. You are seeing a urologist and looks like he/she is looking to see if any signs of the cancer are there. Just cross fingers and hope that it is BPH, infection, irritation and you can easily treat it.
Good luck on your PSMA.