I’m hoping, but not too confident

@asgmiami1 A DRE will raise the PSA so should get the PSA retest first. Just like bike riding, etc. if DRE done shortly before PSA. If immediately after might get the blood draw in before the increase.

@asgmiami1 Hi, recommend you see a urologist for the DRE (and the other stuff, too). Not sure how many DRE's a PCP does so I'm not sure of competence

@bob1955
I understand. But without an official diagnosis and PSA within normal ranges, I don’t think one would see me. But other than a DRE, there’s more clinical level tests we can do that could give us direction.

Have you had an MRI? That would give you more information to work with.

I would think your PCP besides doing the DRE, may consider antibiotics to see if that improves things and lowers your PSA. Some Physicians and Urologists will order an MRI on PSA velocity if other things are excluded such as prostatitis.
While it may rare , there are many people on this site including me (PSA 2 that had doubled from 1 in less than a year) that had significant prostate cancer diagnosed with a PSA below 4 so it is good you are going through the exam process and “ all the stuff”

@ezupcic
No. Kinda just exploring at this point, looking for other clues that might merit an MRI with normal PSA.

@asgmiami1 you might also try a PSE blood test or a MPS2 Urine test. Both are apparently more precise than a PSA for Prostate Cancer. The MRI gives you the size of your prostate in ML which you can use to calculate your prostate density and put your PSA into a context.

As with any other disease, illness, or injury, there is no exact pattern to this disease either. There is routine, but guys react differently to them; that adds greatly to any variability in outcomes.

There are key indicators and key decision points:
> the first is to start PSA testing early and annually (45-ish); if prostate cancer is detected late, you’re already behind in the count.
> the second is to follow the numbers; PSA, % Free PSA, PSA Doubling Time, PSA Density, PIRADS score, Gleason score, and more; if you follow the numbers and act on them (and keep emotions in check), you’ll do well.
> the third is to consider family history

Prostate cancer usually has no symptoms. The prostatitis you had, though it elevated your PSA, is not an indicator of prostate cancer.

PSA is not cancer-specific. The PSA number itself is similar to a “check engine” light in a car; it indicates that something may be wrong, and further checks should be made “under the hood.” Might be as simple as a UTI; might be prostatitis; might be BPH; might be more serious, such as cancer.

Just need to have further checks. No need to panic, or rush to a quick treatment decision, or get overly concerned.

@asgmiami1

@beachflyer gave a great summary.

Your PCP could always give you a referral to a Urologist, if needed.

I would just start calling Urologists amd tell them your PSA increased more than 0.7 from year to year. That is one general guideline in the medical industry.

My PSA for the past 6 years has been between 2 and 2.9.

In June of 2025, my annual result was 4.0

I called local urologist and got 1st available appointment in July 2025.

Prostate was not enlarged, DRE did not find a lesion and no infection indicated by urine tests.

Urologist asked if I wanted to pursue further tests. I confirmed, I wanted further tests.

4K blood test and MRI was completed in Sept 2025. 4K test was in the low-moderate range. However, MRI showed a PIRADS-5 lesion (2cm in length)

Biopsy results were Gleason 3+3 on 5 cores.

My PSA test last month was at 2.0. Two other PSA tests over the past 6 months were also at 2.0.

I do not know the reason, my yearly, PSA test in June 2025 was elevated at 4.0. However, if that test had not been elevated, I would not have scheduled an appointment with Urologist.

I do not know what information insurance will need to approve a MRI. But seeing an Urologist ASAP, is the next step.

Best Wishes.

Here are other tests which may assist in determining what you may be dealing with. Others have mentioned these too.

Discuss with your medical team, which one or ones.

Depending on the results, they may suggest a MRI, preferably multi=parametric

PSA tests by themselves may not be definitive, same for the DRE.
https://www.urotoday.com/recent-abstracts/urologic-oncology/prostate-cancer/163806-a-sensitive-and-specific-non-invasive-urine-biomarker-panel-for-prostate-cancer-detection-beyond-the-abstract.html
https://www.medpagetoday.com/urology/prostatecancer/118778
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Kevin