High PSA and worried

If you're otherwise in good health, I think it would be a good time to see a urologist for followup! Even if you ultimately decide in consultation with a medical team not to treat, you will be proceeding from a position of informed consent.
In general, my understanding is that not screening is to avoid unnecessary procedures that result in more (net) harm than good. Certainly keeping this in mind as a consideration going forward is reasonable, but further diagnostics like a multiparameter MRI are readily available now that weren't so available earlier. Whether to do a biopsy might be more of a question, but that can be reconsidered once you have more information and a fuller medical evaluation, including other factors in your life.
Besides, didn't I read that 83 is the new 73? 😉 Apparently you care about your health or you wouldn't have gotten tested at a mobile blood testing clinic.

Thank you for responding. I appreciate the feedback. I have a 2nd PSA test in 2 weeks then I'll be seeing a urologist. It was a kind of shock to get the results from a random test that normally (screening) wouldn't be done for anyone >80. I actually fibbed about my age to get it in the first place. Naughty me.

It is important to have comparable PSA results for a number of successive tests to establish a PSA trend.

As patients, we are directed to use the same lab provider.

Inferring somewhat that your Urologist is ordering the PSA test/lab.

Age and BPH can raise PSA, in addition to PCa.

My father had a PSA of 11 taken at age 80 in 2010 (reason unknown and somewhat baffling). He must have had a biopsy with 1 "hit", because I remember that he was offered seeds or watchful waiting; chose WW and although he passed at almost 95, I never again recall hearing about his prostate.

I would try not to stress too much and would have confidence that the Urologist will give you good guidance.
For a reference, many here recommend the Patrick Walsh MD's book Surviving Prostate Cancer.
And there is a free downloadable patient guide at PCF.ORG.
Best wishes.

Thank you for your perspective and facts. I will definitely check out the book you reference here. Knowledge is power for sure. The journey begins and like your father, it may well be WW but first I need to get the current status. Meanwhile, finding this forum has been a blessing.

Based on what happened to me, I think it is very important to get a second opinion by some-one not related in any way to the first doctor. The urologist that diagnosed me and then did the robotic surgery came across as a know it all. After the surgery (June 2022) I never went back to him. Then a couple of months ago my primary care physician (who I see only 4 times a year) told me that some tests that I had taken showed that I had cancer in my lymph nodes. This enraged me. I had always been a sexual adventurer, but without my prostate I can't get an erection. I can't achieve an orgasm no matter what I try. I'm 70 years old and I had decided that if I had to give up sex in order to save my life - well I was willing to make that trade off. But to find out the prostate cancer has spread to my lymph nodes makes me furious. I gave up drinking alcohol in 2019 after going into liver failure. I still miss it. I gave up sex 2 years ago, and damn it! I still most assuredly miss that!
How many things can a guy give up before coming to the conclusion that perhaps life is no longer worth living? Truthfully if I did not have 5 rescue cats to care for I'm not certain I'd want to stick around.
But I do have some responsibilities and so I am scheduled for a PET Scan next week. I don't know enough to select either radiation or chemotherapy if it comes to that. But I am certainly not simply following what the urologist who talked me into having prostate cancer surgery says I should do.
Good luck to you.

Thanks for your feedback. I've read that medical second opinions are important and indeed even required by some insurance providers. I will be seeking that resource.
Lots of quality of life issues that you point out. For me, even having a TURP 15 years ago for BPH brought side effect issues including retrograde ejaculation and some loss of sensation.
Wishing you well with the PET scan and that any treatment required fits your need and is successful.

Hey, So sorry to hear about your situation but you could be writing about ME!! Same age, hotshot NYC surgeon to the stars, found out he only removed ONE lymph node. Rising PSA got me to Sloan ASAP. Had MRI, which showed nothing unusual and they've been watching PSA, which is now nearing the .2 threshold for salvage treatment.
You didn't mention - or perhaps I didn't understand - what kind of cancer was found in your nodes by your doctor. It might not be PCa but the PET scan is supposedly specific for that type of cancer so you should know soon enough. But hopefully it is confined to your glands and pelvic radiation combined with hormones - what they've laid out for me - should do the trick.
I'm totally pissed off about the loss of sex as well - limp as a noodle no matter the type of pill. But I DID tell the surgeon that I wasn't coming to him for any other reason but to get the cancer OUT and if he had to damage nerves not to hesitate. His female assistant remarked, "Gee, I've never, ever heard a man say that before!" He replied, "He is no dummy - he wants to save his life." But when I heard about the single node being removed it almost caused me to want to sue him but I subsequently did some searching around and saw that some other surgeons also used this technique so as to prevent lymphadenema down the road. Sloan disagrees, however, so that's that. Please let us know how you make out and I'll do the same. Best of luck, bud!!
AL

Your Urologist will likely recommend an MRI and maybe a biopsy. But don't let that scare you.

Understand that prostate cancer (PCa) is generally slow-growing -- especially low-grade & favorable intermediate-grade PCa.

That is, you probably have time (maybe a lot of time) to research your options.

My Suggestions:

1. Talk with your Urologist about tests he recommends.

2. Don't rush to biopsy -- decide AFTER getting a multiparametric MRI, preferably from a Center of Excellence.

3. Before getting a biopsy, consider getting a PSMA PET/CT body scan. You're injected with a radioactive dye that identifies PCa. (An example is the brightly-lit middle image below.) PSMA PET scan is especially useful identifying PCa sites if you have spread outside the prostate.

4. Old-school biopsies randomly sample areas of the prostate and can miss tumors, especially early-stage small tumors. Instead, get a targeted biopsy (aka MRI-Ultrasound Fusion biopsy), which combines (fuses) your mpMRI with real-time ultrasound images. This allows your Urologist to target your biopsies to areas-of-interest in your prostate. Other areas in the prostate can be randomly sampled as well.

5. Research, research, research. Early on, I found this video helpful:

I concur with the guidance of doing some research, getting another test, and meeting with a urologist. If reading clinical trials is within your realm of interest, your age range is in the upper range of patients so you will find some good information.

I think that advocating for your health with proper maintenance and proper testing are responsible actions, yet sometimes they bring to light things that didn't seem like issues. So, you need to look at this from a life experience point of view and how this fits into past events. You have options, that is a darn good feeling no matter how you consider various outcomes.

You sounded like you needed a hug. I am 74 and done with radiation. Sex is gone because wife 72 had a stroke and breast cancer and is on an anti-estrogen so she has no interest. We still drink a gin n tonic on Friday night out at our pool and firepit and that makes it worthwhile to keep going. Take care of those cats.