PSA up then down

Welcome to the confusion. I would go get the MRI Now. I would also talk to the Urologist about the PSE blood test.

A friend of mine had PSA numbers that would rise then fall and they didn't find PC in him until 3 biopsies later. I have a history of high and fluctuating PSA numbers since age 42 which started this mess. I went from 4.5 to 3.18 to 4.04 to 2.48 to 3.44 and finally to 3.58 6 months later. PIRADS 3 and PIRADS 4 lesions and Atypical cells suspicious for cancer but no definitive findings. I have been on active surveillance for the last 6 months. PSA numbers can be all over the place.

Urologist didn’t even mention PSE test.

Good luck! Hope you are ok!

Your numbers are so low it is really time to relax. Wait three months and see what happens, It’s way too early to do anything with that low a PSA.

Riding a bike before getting the test can get you a higher score

You are fortunate

PSE isn't a general category of test; it's a proprietary screening approach from one specific company that combines the standard PSA test with epigenetic testing (the "E") to reduce the rate of false positives.

In other words, if your PSA indicates you *might* have active prostate cancer, they claim their extra epigenetic testing can refine that to "yeah, it's likely" or "no, probably not," and they've collected some test data to back that up.

PSA variations at < 4.0 ng/ml are not uncommon for the reasons previously mentioned. If you remain concerned, and two subsequent PSA tests that are well controlled (same lab, no strenuous activity, sex, etc for a few days before) still show an increase, I concur with the earlier recommendation to get a PSE test. I also concur with the recommendation to relax, because all studies of < 4.0 ng/ml and especially < 2.0 ng/ml, unless there is a steady and sustained increase in PSA or rapid doubling, the probability of PCa being found is very low. All of my above comments only apply to people that have not yet had a treatment for PCa.

I have been on testosterone therapy for about 15yrs. My PSA has been up and down all the time. My urologist said that there are a number of factors causing this. With cancer, it never goes down. This summer it did not go down …MRI ordered, then biospy, now radiation vs surgery.

It can go up and down if one has cancer. Sure has happened to me while on Zytiga.

Ask for a multi-parametric MRI instead of regular MRI. look for video by Jell Barentsz on youtube. Also, in addition to total PSA, get the % Free PSA test. These two values plus the PSA Density could help.