You are doing great asking these questions.

Two general guidelines to prompt visit to urologist are if either of these occur:

-PSA velocity over 0.7 from test to test
-PSA Over 4.0

You have two years of PSA velocity increases.

I recommend scheduling a visit to Urologist in the next few months. They will test urine for infection and perform a DRE.

The DRE will give some understanding if the prostate is enlarged and will see if any lesions are felt.

This will be some starting point information.

At this visit with Urologist, discuss further tests.
-4K blood test (adds more factors than just PSA)
-PSE test
-MRI

I am 61. In 2022, my yearly PSA increased from 2 to 2.8. In 2025, my yearly test was 4.0. This was enough of a jump for me to visit Urologist for the 1st time in July of 2025.

DRE indicated prostate not very enlarged and did not feel any lesions. Since PSA was only at 4.0, Urologist asked if I wanted any further testing. I strongly stated YES. I knew my PSA had been increasing for several years and wanted more info.

4K blood test was rated at low-intermediate risk for prostate cancer. My PSA portion of the 4K test was only at 2.0 (this was 6 weeks after PSA was 4.0 on yearly bloodwork).

MRI a few weeks later, showed a 2cm Pirads5 lesion. Pirads5 lesion is the highest on a Prostate MRI and indicates the lesion is highly likely to be cancer.

Over the past year, I have had two MRI’s, two biopsies, and other tests. I have at least Gleason 3+4 cancer and lesion is along prostate wall.

I have RP surgery scheduled for next month.

Over the past year, I have had 7 PSA tests. Only two of these tests have been over 2.7

One test last year at 4.0 and one this year at 3.3.

All other test have been between 2 and 2.7. I have had two tests at 2.0

You may not have prostate cancer. PSA may be rising for other reasons. You just want to get more tests and more information.

We are all different. Some have high PSA and no cancer, while others have low PSA with significant cancer.

Some have visible benign lesions on MRI and some have no visible lesions on MRI and have significant prostate cancer.

Best wishes and keep asking questions.