Rising PSA: Does it warrant MRI?

I would push for MpMRI

What’s important for prostate size is how many cc it is, The largest diameter doesn’t tell anything.

You could go into a urologist and get a digital rectal exam to see if he feels something.

5.3 Is high for a normal size prostate. Do you have BPH issues, any urinary problems, They can cause the PSA to be higher.

Did you have sex or ride a bicycle before going to get tested? That can raise your PSA.

My urologist ordered the MRI-biopsy combo when my PSA was between 4 & 5, so I’d think that wouldn’t be out of order for you.

Add mowing your yard with a riding lawnmower to the list of “Do not do before PSA” - basically, anything that jiggles your prostate is suspect.

I think next step would be an MRI. If not for anything but peace of mind.

At a minimum you should get retested (including Free PSA) after a course of antibiotics and refraining for 2 days prior from activities that will increase PSA. If still high can go to mpMRI. You have already waited 1 year. I would not push it to 2.

I forgot to add. Too many things going on today

If the other things I mentioned aren’t an issue, then you need an MRI.

@hamlet
You might want to get the PSE blood test. 94% accurate vs psa test alone. The test report will tell you whether you are likely, or unlikely, to have prostate cancer. Part of its design was to help people decide whether a biopsy should be done. Here is a link to Oxford biodynamics PSE product page. https://www.94percent.com/

If/when you get an MRI, (in addition to what others’ have recommended based on their personal experiences) also check your PSA Density. If your PSA is getting higher because your prostate is getting larger, that’s an entirely different situation to deal with.

My psa at 68 was 4.9, but was up substantially from 3.75 the year earlier, slightly enlarged prostate clean dre, urologist recommended mri, that was ambiguous so had a urine biomarker test came in high so thus the biopsy waiting for results any day now.

I'm 68. My PSA went from 3 to 5 in the span of three years. I have a larger prostate than you and the PSA density is quite low. Nevertheless, I had a multiparametric MRI which flagged an area as suspicious. A biopsy confirmed the worst. No family history of prostate cancer.

I'd not wait for an MRI. All the best.