Rapid rise in PSA to over 10

A large prostate or BPH can cause your PSA to be high. Going up to 10 that quickly though is concerning. A friend of ours had a PSA of 50 and had a few biopsies and they never found anything. He died of a completely different cancer.

Have you had BPH? Have you been told your prostate is large? I would consider having a biopsy Unless one of those conditions exists.

Rising to 10 in a month from 4 IS quite unusual.

@jeffmarc Thanks Jeff. Yes I’ve had BPH for a decade with the usual urination issues but never a PSA like this. Appreciate the reply

I had RARP last year at age 70. I'm not a medical professional so take what I say with a grain of salt. I think the MRI is a great next step. You want a 3T MRI (if available) as it provides better images that the older 1.5T units. If it shows a lesion they'll probably want a biopsy. I'd suggest a fusion guided biopsy (if available) so then you're pretty certain they sampled the lesion. If the MRI doesn't show any lesions, I'd suggest staying on a frequent schedule of PSA testing until you figure out what's going on and try to get a PSE test if that's an option. Basicly, if you do end up having PCa you'll have many more options if you catch it early, so you want to stay on top of this until you're pretty sure you know your status. Best wishes.

@vincenzo66
Here is a discussion from 2024 on Mayo Connect on Oxford Biodynamics PSE test. Its worth contacting Oxford Biodynamics and your doctor regarding its use. It may save you an MRI and give you a supposedly 94% accurate opinion vs 55% with PSA alone.
https://connect.mayoclinic.org/discussion/pse-test-for-prostate-cancer-before-an-mri-and-for-re-occurrence/

Additional tests or calculations to track to help gain more insight:
> with BPH, what is your PSA Density?
> do you have a UTI?
> do you have prostatitis?
> what is your % Free PSA?
> have you had a PSE test?

Once you’ve had your MRI, there will be additional tests or calculations to track to help gain even more insight.

Take it one step at a time.

@vincenzo66
Antibiotics have been shown to make a big difference in BPH and reduce the size of the prostate and reduce the PSA, all with one type of treatment.

Ask your doctor if that would make sense for you.

@brianjarvis Thanks - no overt evidence of a UTI a month ago. Not sure how they diagnose prostatitis - guess we’ll see what the MRI shows. Appreciate the reply.

@jeffmarc will absolutely do antibiotics if there’s a suggestion of a bacterial infection. Thanks for the thoughts.

@bens1 thanks - already scheduled for the MRI but I’ll ask the urologist if I can have this done. All the best.

@vincenzo66

Prostate infections can be incredibly difficult to detect. That’s why doctors will often prescribe antibiotics without proof of infection.
But they have been shown to be effective even in the absence of infection.
It is either due to an anti inflammatory effect or an infection that can’t be found.
The MRI is very prudent. But I would expect with a jump if that magnitude, you are dealing with a flare up of some sort.
Like Jeff, I have a friend that had a PSA spike of 25 and no solid reason was ever found.