Husband's elevated PSA level: What could it mean?

@wheel1
Thought you might be interested in this table. The ExoDx Is only 50% accurate according to this table. While the PSE test is accurate to 94%. It’s a blood test so pretty simple to get a sample.

@jeffmarc
Another example how quick technology is changing. I wish this had been more common a few years ago. I like anything non invasive, although after the prostatectomy I guess invasive shouldn’t matter anymore

@wheel1
Considering that I get a blood test every month For the last eight years, that never does seem invasive. After four reoccurrences my PSA Needs close tracking.

@jeffmarc We are definitely going to request a PSE from my husband's PCP. From what I read on it, at 94% accurate, it provides a thorough picture. I am so grateful for your advice, Jeff, and am sorry you've had to endure 15 years of this!

@katebaker

Fire up a pit of coffee and read this.
https://www.urotoday.com/conference-highlights/ses-aua-2026/ses-aua-2026-prostate-cancer/167595-ses-aua-2026-pathways-for-prostate-cancer-evaluation-guidelines-tools-and-best-practices-to-optimize-psa-based-screening.html
Kevin

@jeffmarc Awesome Jeff!!! I will be making some call!!
Thank you so much!!

@katebaker - just wanted to drop a quick note to say that I had my RP done at The James back in January, and have been there for two MRIs and one saturation biopsy previously, and that I have nothing but good things to say about the level of care I’ve received on every visit. They handle all my urologic/PCa needs now.

Good luck!

Hello - There are many reasons why men can have prostate cancer. You're right, family history is a leading indicator. However, I do not have any and I just finished my last radiation therapy and androgen denial therapy a few days ago. I don't drink and smoke, either. My PSA rose from 0.4 in 2001 to 4.0 in 2020 then 5.9 in 2025. I did the MRI then biopsy that showed I had tumors in my prostate. My urologist told me I can wait and monitor it but I wanted to treat it as soon as possible because I was already 70 years old. You husband's case is surely different but the level being 4 is the highest normal for PSA. However, it did go up to 6 like you said and I'm wondering if you have previous results before that or did he have symptoms that prompted that PSA test? I would wait for the results of the biopsy because that would be really definitive. Hopefully, it's negative but if not, early treatment is the best option. I have known men who found out at stage 4. Good luck.

It’s always best to get a second opinion. Especially with prostate issues. It could just be BPH. PSAs can fluctuate based on numerous reasons. I had mine checked every 4 months for 4 years. I swung from 4 to 9.7. Currently 8.6. One Urologist told me hurting my back can cause an elevated PSA. I recently read that ejaculating the day prior can cause a different reading. So if your comparing one month to the next you’re not comparing apples to apples unless all the “factors” are the same.

Hi,
I would think an MRI would be in order to determine the size of his Prostate and if any suspicious areas show up before the biopsy is done. An enlarged Prostate will raise your PSA, even a PSA of 4 is high. A second opinion from another doctor/hospital might not be a bad idea.
Dave 3+4