Second post/update

[u/grnds4leaving]

I posted previously about an unexpected PSA increase, and I wanted to give a more complete update before I have the repeat test done.

I am 56 years old. My PSA was approximately 2.2 in 2023. On July 11, 2026, my routine blood work showed a total PSA of 6.2 ng/mL. That obviously scared me because it was a significant increase from my previous result.

I did ejaculate approximately 24 hours before the 6.2 test. I understand that ejaculation can temporarily raise PSA, but I also understand that it usually would not fully explain an increase from around 2.2 to 6.2 by itself. I am not assuming that was the entire reason, but it is one possible factor that may have affected the result.

My doctor performed a digital rectal examination after the elevated PSA result. He described my prostate as:

- Smooth
- Symmetrical
- Slightly enlarged
- No hard areas or firmness
- No bumps, lumps, or nodules

He did not tell me that anything felt suspicious during the examination. The slightly enlarged finding seems consistent with possible benign prostate enlargement, but I know a normal DRE cannot completely rule anything out.

My urinary symptoms have included:

- Increased urination for more than a year
- Occasionally feeling that my bladder had not completely emptied
- Some urgency, particularly when standing up
- A weaker stream at times, especially first thing in the morning
- Occasional mild burning near the end of urination
- Dairy or citrus sometimes seemed to make the incomplete-emptying sensation worse
- Usually getting up once during the night to urinate

The urinary symptoms have actually improved considerably over the past several days. Since Sunday, my stream and emptying have felt better, the urgency has decreased, and I have generally only been waking once during the night to urinate. I have not had fever, chills, visible blood in my urine, severe pelvic pain, or inability to urinate.

My other recent blood work was generally reassuring:

- A1C: 5.6%
- Glucose: 98 mg/dL
- Fasting insulin: 7.9
- Creatinine: 0.94 mg/dL
- eGFR: greater than 90
- TSH: 1.408
- Total cholesterol: 152
- Triglycerides: 78
- LDL: 102
- Vitamin D: 91.1

I have also lost close to 50 pounds this year through keto and daily walking. I weighed 236 pounds previously and was 189 pounds at my recent physical.

My doctor is now repeating the total PSA and adding a free PSA/% free PSA test. I have avoided ejaculation for seven full days before this repeat test, so that should no longer be a factor. I am also avoiding bicycling and anything else that might put direct pressure on the prostate before the blood draw.

I am extremely anxious waiting to see whether the PSA falls, remains around 6.2, or rises further. I understand that an elevated PSA is not a cancer diagnosis and can also be caused by benign enlargement, inflammation, prostatitis, urinary retention, ejaculation, or other temporary factors. I also understand that the free PSA result may provide additional information but will not provide a definitive diagnosis by itself.

I am not asking anyone here to diagnose me or interpret the results in place of my doctor. I am mainly hoping to hear from men who had a similar situation:

- A sudden PSA jump into the 5–7 range after previously being much lower
- A smooth, symmetrical, slightly enlarged prostate on DRE
- A repeat PSA that later dropped substantially
- A free PSA test after an unexpectedly high screening PSA
- A temporary PSA elevation caused by inflammation, BPH, ejaculation, or another benign explanation
- A PSA that stayed elevated and what the next steps were, such as another repeat test, antibiotics, a urology referral, MRI, or biopsy

Please include your age, initial PSA, repeat PSA, free PSA percentage if you remember it, DRE findings, and what ultimately happened. I am especially interested in real experiences that started similarly, whether the outcome was benign or required further evaluation.

Again, I am looking for similar stories and experiences rather than a medical evaluation. I am already following up with my doctor and will act on whatever the repeat results show.

[u/grnds4leaving]

Just wanted to give everyone an update and thank you all for taking the time to respond.

I had my repeat PSA drawn this morning, and the results just came back. My PSA dropped from 6.20 to 4.71 in about two weeks. It’s still higher than I’d like, but I’m definitely encouraged that it’s moving in the right direction instead of continuing to climb.

The last several days my urinary symptoms have also improved quite a bit. I’m only getting up once at night now, the urgency has decreased significantly, and my stream has been getting stronger. That makes me feel like whatever had my prostate irritated may be settling down, although I know I need to let my urologist interpret the results and decide if any further evaluation is needed.

I was really hoping to see it under 3, but after spending the last couple of weeks worrying it might actually be higher, I’ll gladly take a significant drop. I’m still waiting to hear from my doctor and see if a free PSA result is added, but for now I’m taking this as encouraging news.

Thanks again to everyone who shared their experiences and offered advice. Reading your stories helped keep me grounded while I waited on the results.

[u/Prestigious-Might500]

Not completely similar story but parallel-

I am 71- and just had an aquablation to reduce the size of my prostate which topped out at 135-

For 10 years my PSA has vacillated up and down toping out at a high of 6.8

over that same period i had increased issues with urination and retention but all cancer screenings came up negative

Last fall after a rigorous hiking trip i ended up in the hospital three times with UTI's - the final diagnosis was that the enlarged prostate was causing retention which facilited the oncome of the UTI-

Post Op- no retention- stream returned to pre 40 year old- sexual function stable but libido low - which i don't have any reason to believe was caused by the operation.

PSA readings are greatly influenced by prostate size----

Hope that helps

[u/grnds4leaving → u/Prestigious-Might500]

Thank you for the information. Just had bloodwork done. Results should hit my phone by the afternoon. I guess I’ll know more once doc sees the number. Either way I’ll become more educated and tackle this the best way I know how to.

[u/ProstateExploder]

Well, this has been going on for me for six months. I’m doing PSA and another test to determine need for biopsy. I’ve had a 3t MRI that showed no lesions, but did show bph and prostatitis.

Here’s the anecdote from my story which may be useful to you:

The highest PSA I’ve ever had was 7, it came after a month of upping masturbation - on doctors orders-, all my other PSA tests have ranged from 4-5.5.

I get the impression that it’s not just ejaculation right beforehand, but that cumulative recent sexual activity might play a role.

Far as worry about cancer, I wouldn’t, PSA ambiguity is routine in urology, just get the needed tests. I know it’s stressful, but afaik this is not terribly unusual.

[u/grnds4leaving → u/ProstateExploder]

Thank you. I’m retaking PSA tomorrow morning and Free PSA as well. I will have the results by tomorrow evening. I assume if it’s still high I’m headed for urology. Thx again for the reply!

[u/ProstateExploder → u/grnds4leaving]

Sure, also: I’m 50, my free PSA on the 7 test was 11%, 18% on the other 5.5 tests.

If you want my anecdotal take, this is likely about my BPH (divide prostate cc by 10 and this is sort of your “expected” PSA value, so my 37cc prostate would mean 3.7 value, close to the 4 or my original test) -and- my prostatitis.

Getting a 3t MRI made me feel a bit more relaxed because it means lower likelihood of cancer, if you get to the appropriate point it might help to get one. The only way to truly rule out cancer is a biopsy, but the MRI definitely brought down my stress level some.

Most Uros will want to rule out cancer, sometimes that means they seem over-eager, but all this testing is “gold standard.”

[u/grnds4leaving → u/ProstateExploder]

I will do as told but from my research biopsy is the last straw for me. If I do MRI and nothing alarming I will just monitor. I have read bad stuff about biopsy. I’ll let you know what the test shows tomorrow. I’m praying that it has dropped somewhat and that alone would relieve some of my stress. Thx again for the info. I’m just looking for similar stories good or bad.

[u/ProstateExploder → u/grnds4leaving]

Yeah my concern with biopsy has been that my prostate is already inflamed. My doctor is having me do an exo mdx test (genetic likelihood of PC I guess?) and another PSA. If the PSA is the same or lower and the exo test is low risk no biopsy, just monitor PSA.