Very High PSA: What might cause a sudden increase?

I was getting my PSA checked every 6 months until I had a 9.4. The recheck 2 months later was 12.3. My urologist/surgeon recommended a prostatectomy immediately . He later told me the prostate was fully engorged with cancer. I had the surgery just in time. With your PSA at 50.64 your urologist should be recommending immediate surgery. If they won't, you need to see another doctor.

I just had a MRI and a pet scan a couple of weeks before this last blood test and it only showed the original 3+3 cancer that I already had my doc offered to try a antibiotic I turned he down I just called and told her I changed my mind and wanted to try the antibiotic.

PSMA PET scan

I remember when it first came out. They called it .. watchful waiting. I guess that sounded too stupid, so they gave it a high tech name.. active surveillance. A fancy term for doing absolutely nothing.

Im personally not a fan of playing patty cakes with cancer.

The other thing. The PCa industry has an imaging problem. They have the ability to shoot things much smaller than they can see. They cant see anything until it gets like 5mm in diameter.

Then theres the 12 pin biopsy.
Some guys get multiple biopsies before one finally hits the cancer.

The urologists act very very confident.. but in the end they are attempting educated guesses as to what is down there.

Here is a good website to compare odds of cure for the major treatment paths. You have to determine your stage, low risk, intermediate, or high risk (risk of recurrence). So if you are intermediate, pull up the intermediate chart and you can see the odds of 10-20 yr survival, etc. based on the treatment you pick.
https://www.prostatecancerfree.org/compare-prostate-cancer-treatments/
It is best viewed on computer or just print it on paper. Not so viewable on phone.

To make the graphs easier to read, i drew a dot on the endpoints of the elipses, and then drew a line through the dots. This turns the elipses into lines.

December of 2021 biopsy showed I had a 3+4 cancer in one core I sent the biopsy to John Hopkins they down graded it to 3+3. I started watchful waiting. Blood test every 90 days average around 5 PSA. In January 2023 I had a second biopsy no new findings. in June I had a MRI and a PET Scan nothing new. In July my blood test was 50.4. I tested 2 days later it went down to 43. I am having another test Tuesday . Any Idea what could be causing such a rapid raise in PSA ? I have no symptoms of an infection, but the doc gave me a antibiotic anyway.

The PSA is very high. A 3+3 would be low risk though. The only caution here is that biopsies are those taken and not all of prostrate. It is why when you get radiation treatments they treat the entire prostrate as the biopsies might miss an area.

When you said every 90 days your PSA is around 5. A 5 is above normal but below 4 is normal. But the blood test you listed in your post said it was 50.4. That is quite a difference? Is this number the PSA test results also?

Do you bike ride? Are they doing a Free PSA or just PSA?

I don't bike I am a 72 year old runner but I pulled a glute muscle and have had no exercise for about 3 weeks before my test. and yes that number was the PSA test result. I am really concerned about how it could go high in 90 days with out the MRI and PET scan not showing any additional cancer. If it is still that high when I get my test result tomorrow I am going to talk to a radiologist at the Nebraska Med Center about treating it instead of watching it