my 6 year post proton radiation psa rising 2.262

I am plodding along with prostate cancer.
I am falling off Loma Lindas med center chart for recording my PSA values.after 64 months this is my biggest jump from 1.469 6 months ago to 2.262. My urologist here is currently not recommending restarting Lupron. I expect my next 6 month visit he will? although very controversial post radiation failure? when my Buddy and patient pard hit 8 he knew doom was near. he did not opt for ADT nor Freezing. he went in a year, it was grusome. I now think my bad back and knee may be infected? but then I have had a bad back for 30 years. Dr Chodak says bone scans and MRI are useless until psa exceeds 10.

Could be a bounce, even after six years. Ask for another PSA test right now and another one in six months. And refrain from activities that might raise your PSA prior to the test.

I doubt that the pains in your knee and back are related to prostate cancer.

Sorry to hear about the PSA increase. After 6 years I suppose it could be a bounce, but not likely. Prostatitis is always a possibility no matter how long it's been since treatment if you have a history of it.
I did not understand parts of your signature. You said "Gleason score 4+5=9 Perineural invasion in all fragments", than later you said "Gleason score 3+4=7, stage T2b at MDA".
What is your nadir since treatment?

Thanks for the clarification. If MDA and Hopkins both said 4+5 that's difficult to set aside. I can understand why you chose the treatment you did. So, using 2.0 over nadir as BCF, what would your PSA have to be?