What constitutes a big jump in PSA ?

Hi Rich,

I can understand your concern, mate. I've got a family history of the disease. My dad and younger brother had it. It's what finished my dad off. So far, me and my brother have survived it and doing fine.

Like you, I was initially diagnosed with low grade, low volume, Gleason 6(3+3) my PSA was only 5.6. The cancer was prostate confined and I went on active surveillance. 

My PSA fluctuated between 6 and 7. About two years later, a belated follow-up MRI showed disease progression. A follow-up biopsy confirmed this. The disease was eventually graded Gleason 9(4+5) and had breached the capsule. I had RARP.

Despite my AS failure, so long as you are closely monitored, I'm still a great fan of it.

I'm not medically trained, but from my experience and from what I've learnt about the disease, I'd be asking for a follow up MRI and if necessary a follow-up biopsy. 

Your slight rise over the past year or so could be caused by a non-cancerous prostate conditions such as BPH. It could be that your low grade cancer has just got a bit bigger and producing slightly more PSA. It could be that your initial biopsy, like mine, missed higher grade cancer cells, which could also elevate PSA levels.

I think the current NICE guidelines recommend a follow-up MRI between a year and 18 months after starting AS so you're about due one anyway.

It's a tragedy about your brother, but I wouldn't worry too much that you have exactly the same aggressive cancer that he obviously had. By all means stress your concern to the 'powers that be' and they may decide it's worthy of genetic checks.

Good luck, mate.👍

Please keep us updated.

Edited by member 17 Dec 2025 at 22:56  | Reason: Typo

Hi Adrian,

Thanks for that - appreciate you letting me know. 

I am having a few issues which may well not be prostate related (e.g., lower back pain - as I am a keen runner back pain is not a new issue but this time it is not going away) but cannot work out what else it could be having seen various "specialists" over the last few months re osteopaths, physios etc and with the slight rise in PSA keen to find out what is happening. 

This may well be paranoia on my part as other friends who have been diagnosed had PSA scores from 140 - 170 and my score still feels very low in comparison.  It is useful to know a low score could still be significant.  My latest results (I get tested every 3 months) only came in last week so still to hear back from the urologist on next steps.  It will either be to wait another 3 months (!) or hopefully move on to another MRI / biopsy.  My previous MRI came back clear when PSA was 5.3 and it was the biopsy that scored an initial hit.  

Interesting times, .....................

Thanks again.