Ultrasensitive PSA test results: Should I be concerned?

I'm a very active person I walk 12 miles daily and weight lift 5 days per
week, I did the 12 miles and weights 2 days prior. I'm hoping that's what
it is because the same thing happened 3 years ago, this time on my retest
the doctor said only very lite walking the week prior.

@ginger38314, any update? How are you doing?

I have a retest on 3/17, than either way a follow-up wit h an urologist a week later, doctor says no 12 mile walks or weight lifting the week prior, just want to get this issue resolved and to quit worrying about it all the time, other than that physically I feel good, thanks.

in a previous discussion @handera mentioned the MPS2 Test which studies show is maybe even more accurate than the PSE and PSA tests for detecting cancer in the prostate. Worth researching.

Right now I'm going in for retest in two weeks. Even if it goes back to normal I'm going to request an mri, thanks

Suggest a PSA2 test

5.09 PSA is still relatively low, and it has not doubled in any 6 month or year period of time so that’s a good sign.
FYI: A PSMA scan is more conclusive for determining if it’s cancer than a PSA lab test

Regarding your situation —> You mentioned that your urologist said you “…had a very large non-nodular prostate..”
—> How large is your prostate?

You also mentioned that your urologist said “…not a concern for cancer at this time.”

He’s apparently aware that larger prostates can produce more PSA without it being cancerous. Measure this by calculating your PSA Density.
—> What is your PSA Density?

—> What is your % Free PSA?

Also, have them test for other conditions that might cause a PSA spike: UTI, prostatitis, or anything else that might cause PSA to increase abnormally. (Did they do the DRE before or after the PSA test?)

With your concern about an elevated PSA, have you had any other liquid biomarker tests (just to have another datapoint)?

Mayo Clinic uses an age-based PSA range (see attached). Your PSA is only slightly elevated based on that chart.

If after all those considerations you’re still concerned, an MRI would be your next step.

I agree, last August I went in for the dre on my own accord. He said non-nodular large prostrate I have a retest in 2 weeks will know more then, thanks

Ok, the age old dilemma, how do I know..."?

PSA and DRE by themselves may not answer that question...

As others have pointed out, other factors may be in play such as UTI...

I've seen in discussions about pre-PSA testing things to avoid such as sex, bike riding...can't say that I've seen discussion about walking and lifting weights but hey, possibly?

There are other tests which may indicate yes or no.
https://www.urotoday.com/recent-abstracts/urologic-oncology/prostate-cancer/163806-a-sensitive-and-specific-non-invasive-urine-biomarker-panel-for-prostate-cancer-detection-beyond-the-abstract.html
https://www.medpagetoday.com/urology/prostatecancer/118778
https://www.google.com/search
https://www.google.com/search
Discuss these with your medical team. If they see value, the results could then guide a discussion about doing a MRI, potentially a MPRI.

I understand that finding its way into mainstream clinical practice is relying less on the TRUS biopsy and more on tests and imaging such as I listed. Still, old habits die hard in mainstream clinical practice so your medical team may need a nudge.

Kevin