New to this: PSA jumped from 2.2 to 3.9 in a year

I'd do the antibiotics and another test. If the PSA is still high, I'd go to a urologist.

It's probably nothing, perhaps an infection. Could be a lot of things so don't be alarmed. However, don't ignore it, although we are rare, there are young 40 year old guys like me who get it.

Sounds like you have the right plan.

Chances are it's an infection, so take your doc's advice and do the antibiotics. Even if you saw a uro, he'd probably just give you antibiotics at first.

I'm going to say something that will get me flamed for sure by some here but here is how I feel.

People like me are the exception. We're too young for this. Sure, you could also have it, but you probably don't. Reading boards like this or reading about PCA at "this stage" of your journey is pointless and counter productive in my opinion. You'll only get worked up. Take the antibiotics, do the blood test and then take it from there.

"I haven't been able to find much information on a PSA level spike like mine did. Is that size of a jump a sign of prostatitis or PCa?"

No one can tell you that. People with low PSAs can have cancer too (and by low I mean like 1.5).

Based on a one-time PSA rise getting it rechecked is the "now" part of it and if it is still high a biospy might be the "then" part of it.

There is something called free PSA: "A small amount is not protein bound and is called 'free PSA'. In men with prostate cancer the ratio of free (unbound) PSA to total PSA is decreased. The risk of cancer increases if the free to total ratio is less than 25%." (from Wiki). I'd be sure to get that number too because it can help decide whether or not a biopsy is the next step.

And, my urologist told me to refrain from sex, bike rides, etc. for like 5 days before a PSA.

http://prostate-cancer.org/what-every-doctor-who-treats-male-patients-should-know/

This is the best article around about PSA. It was written by Dr Strum to help doctors distinguish between a normal occurrence and cancer. It will help you in formulating questions for your doctor when discussing your results.
JohnT

Lon111
Let us know how you get on. Hopefully the antibiotics will do the trick and you’ll get a good PSA result on the 18th.
Easy to say, but try to put it out of your mind until then.
48 hours seems to be the consensus when it comes to avoiding sex/ejaculation, cycling, horse riding etc before a PSA test.
Good luck
Susan
x

To me a key here could be that your doctor mentioned a slightly enlarged prostate. Was this enlargement mentioned a year ago during your previous DRE?

The enlargement could be a natural thing that goes along with aging in most men. It is a non-cancerous condition known as BPH. You've probably seen it advertised on TV all the time in commercials to relieve urinary symptoms. Have you noticed any difficulty in urinating such as hard to start, weaker stream, frequency, etc.?

The thing to realize is that it is prostate tissue (including prostate cancer, of course) that creates PSA in our bloodstreams. If you have an enlarged prostate, that means there is more tissue involved. And, more prostate tissue = more PSA = higher PSA readings.

If your doctor did not notice any enlargement last year, the jump in PSA could possibly be attributed to the larger prostate.

ONE CAUTION though is that it is possible that a genuine case of BPH could also be masking the presence of PC. Only a biopsy can determine that. This is what happened in my case.

Here's wishing you the best,
Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-firm erections now happening 14 months post-op & slowly getting a bit stronger.

My stats were almost exactly the same as yours, Lon. I had just turned 42 at dx. Dr. put me on an antibiotic and after a couple of days I thought it would just be better to know. The biopsy was scheduled after finding a uro that I was comfortable with at Hopkins... I live in Baltimore. Two days after the biopsy, "You have G6 PCa. Come in and we'll talk. I'll have an Oncologist here too." Talked to both of them, decided on surgery. My uro/surgeon said not to wait a year as he felt a nodule and was concerned that waiting much longer might allow it to escape. OK. Three months later I was on the table for an open Radical Prostatectomy.

Do what your personal constitution allows. If you're concerned, opt for the biopsy now. If you can wait out the month with the antibiotic, wait it out and have another PSA.

I will share what the Hopkins guy told me, "There's no reason why a man of your age would have a PSA above .5 without an infection or significant enlargement. I don't suspect either. I'll lay odds you have cancer. With the modest rise, it's likely very manageable at this point. But we won't know for sure until the biopsy results."

There's nothing to worry about until there's something to worry about...