Ultrasensitive PSA test results: Should I be concerned?

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

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.

That happened 3 years ago was elevated layed off any strenuous excerize,
after retest dropped 2 points.

@brianjarvis

And I think CDC is essentially the same on screening standards. I would have totally slipped through the cracks on PC. All my psa were below trigger thresholds. If I had not been accidentally biopsied and found Gleason 7- 15 years ago with a psa of point 3 and monitored Active Surveillance (15 years) I would have likely died of PC. I’m over 70, (age 70 I was below psa of 2) with a pre treatment psa that rose to 6.3. Biopsied with G8. Treated. Time will tell if successful. Currently psa is < .02.

@ginger38314

Glad you had the results you did after making adjustments in your pre-draw routine.

I didn’t read the other comments, but thinking to the day you had blood drawn for the recent PSA, did you have sex the night before? PSA rises with sexual activity, and decreases within a day or so. Also, active, dedicate serious bike riders who ride on a racing saddle (most often) are known to have elevated PSA levels a day or two after a long ride.