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PSA fluctuating between 5.6 and 7.5 - should I be concerned

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User
Posted 25 Apr 2026 at 18:28

Hi folks,

Just checking in and looking for a bit of feedback on experience with a fluctuating PSA and at what point any action was taken.

My PSA has jumped from 5.6 to 7.5 over the past 12 months (usually tested every 3 months albeit latest 6 week test dropped back to 7.1).

Urology don't appear concerned and looking to hear back in another 3 months.  This however represents approx 3x the "standard" velocity of 0.75 and surprised I have not been called for an MRI (in Scotland).

Previous MRI's have been clear but subsequent biopsy in Sep 24 triggered a diagnosis and Gleason score of 6.  

I appreciate these numbers are all at the low end of the scale but family history in this area is not good as my brother was diagnosed late and passed away age 52 (he was my older brother at the time and I am now 62).

Also the various activities that can cause PSA to fluctuate don't apply as not currently cycling and also been married over 30 years !!!  I do however keep fit and active in the gym and running but not aware this causes issues.

Any thoughts / past experience on when Urology start to get excited and should I be seeking a second opinion ?

Many thanks

Richard

 

User
Posted 19 May 2026 at 10:18

Hi Richard,

My name's Liam and I'm the Risk Information Officer here at Prostate Cancer UK.

I can understand your concern, especially given your family history. If you'd like to speak to someone about your situation, our Specialist Nurses provide information and support to men at all stages of their prostate cancer journey. You can call them on 0800 074 8383 - lines are open Monday to Friday from 9am to 5pm (10am-5pm on Wednesdays). You can also contact them via email and live chat.

Best wishes,

Liam

User
Posted 19 May 2026 at 11:42

Looking back, you seem to be on Active Surveillance.

PSA can fluctuate, but the fluctuation is unlikely to be cancer related. Cancer tends to cause a steady upward trajectory, so if you see PSA reduce but you weren't having any treatment or taking any supplements which impact PSA levels, then the previous raised level probably had some other temporary factor also responsible for at least some of the increase. There are some things like ejaculating which will temporarily increase PSA, possibly riding a bike or a horse. Also, some viruses, but most particularly COVID which causes raised PSA for a month or so afterwards, and some COVID vaccinations too. Prostatitis (inflammation of the prostate) and a UTI will both temporarily increase PSA and take around 6 weeks to recover after the inflammation/UTI has gone.

I would plot your PSA results on a graph against time. That's the easiest way to see what the trend is. Generally, to spot a trend, you need 3 readings each at least 3 months apart. (Readings closer together may be subject to more noise than the trend you're looking for.) When you have a graph, it's easier to see and dismiss temporary raised outlier points which probably have some other contribution which isn't cancer related.

User
Posted 06 Oct 2026 at 13:11

Hi Gi,

Many thanks for responding.

I have been tracking and graphing my psa / trend since 2015 (when my brother was diagnosed).  It was fine initially until it then started to track upwards a few years ago.  It has since peaked at 7.8 before dropping back now to 6.8 (although now creeping back up).

I was diagnosed 2 years ago now but with a Gleason score of 6 and told it was low risk.  While that sounds good, my brother’s psa was only around 10 when he was diagnosed stage 4 so slightly paranoid about this.

Both MRI’s have been clear to date, no lesions and it was the biopsy that picked up the cancer.

The psa is not consistent and appears to go up and down for no obvious reason.  I used to cycle a fair bit but since retirement not so much as I regularly cycled as part of my commute.  I am a keen runner and have run 23 marathons / ultramarathons in the past 10 years but an ankle operation 2 years ago has slowed me down.  At the moment my main focus is strength training in the gym and injury recovery to get back to the ultra running 🤞🤞

The psa is up and down and not consistent but for now looks to be staying around 7 (average) although I also track if increasing > 0.75pa.

Key will be the next MRI as you say and due next Oct unless psa suddenly creeps up again.

Thank you again for your message and will keep tracking the trend. 

Regards

Richard

Edited by member 06 Oct 2026 at 13:16  | Reason: Not specified

User
Posted 06 Oct 2026 at 18:44

Hi there,

I have been getting 3 monthly psa checks for the past 3 years now and have had 2 MRI scans and a biopsy but no other treatment (other than Tamsulosin).

Regards

Richard

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User
Posted 19 May 2026 at 10:18

Hi Richard,

My name's Liam and I'm the Risk Information Officer here at Prostate Cancer UK.

I can understand your concern, especially given your family history. If you'd like to speak to someone about your situation, our Specialist Nurses provide information and support to men at all stages of their prostate cancer journey. You can call them on 0800 074 8383 - lines are open Monday to Friday from 9am to 5pm (10am-5pm on Wednesdays). You can also contact them via email and live chat.

Best wishes,

Liam

User
Posted 19 May 2026 at 11:42

Looking back, you seem to be on Active Surveillance.

PSA can fluctuate, but the fluctuation is unlikely to be cancer related. Cancer tends to cause a steady upward trajectory, so if you see PSA reduce but you weren't having any treatment or taking any supplements which impact PSA levels, then the previous raised level probably had some other temporary factor also responsible for at least some of the increase. There are some things like ejaculating which will temporarily increase PSA, possibly riding a bike or a horse. Also, some viruses, but most particularly COVID which causes raised PSA for a month or so afterwards, and some COVID vaccinations too. Prostatitis (inflammation of the prostate) and a UTI will both temporarily increase PSA and take around 6 weeks to recover after the inflammation/UTI has gone.

I would plot your PSA results on a graph against time. That's the easiest way to see what the trend is. Generally, to spot a trend, you need 3 readings each at least 3 months apart. (Readings closer together may be subject to more noise than the trend you're looking for.) When you have a graph, it's easier to see and dismiss temporary raised outlier points which probably have some other contribution which isn't cancer related.

User
Posted 20 May 2026 at 14:08

Hi Andy,

Thanks for your reply.  I am aware of the reasons that cause PSA to fluctuate and none of these currently apply (ie no cycling, etc etc).  Also as far as I am aware I have not had a UTI.

In the meantime (and I have been graphing this), over the past 12 months although the PSA levels have fluctuated I have gone from 5 to 7.5 (and then dropping back to 7.1) which is still approx 3 times the "standard" rate of 0.75.  I was surprised not to be called in by urology for an MRI at this point so am now counting down to my next 3 monthly test and see where that lands.

I am interested to find out what experience people have had with PSA at this level and how much I should be chasing this up.

Kind regards

Richard

User
Posted 20 May 2026 at 14:09

Thanks Liam - I might just do that.

User
Posted 06 Oct 2026 at 02:50

Hi Richard

Appreciate its a bit late to this thread - I've been plotting 3 monthly PSA results for the last 18 months and they've been between 6.2 and 8.8, with a weighted average around the mid 7's with 3 monthly variations of up to 2.2. Two years ago it was a PSA of 5 when I had the initial MRI and follow up biopsy of 3+3.

Having test results cross referenced to cycling activity the spikes have been after long distance offroad treks - last one was 220miles with 19k ft of climb across Scottish Highland tracks. 

My last two mpMRI's a year apart showed exactly the same with no lesions and rated T1c. For piece of mind, can you get an updated MRI to compare to previous ones? My first MRI was biparametric and gave far less focused results and higher risk scores than later mpMRI's.

With these latest mpMRI results, the Urologist doesn't seem concerned about the PSA ranges here so long as there's no prolonged PSAD (ratio of PSA to prostate size in ml) of 0.25 or more for 3 consecutive results. Am presently averaging just below 0.2. 

I have read that physical exercise other than cycling can effect PSA levels - especially if core strength / weight lifting and cardio in nature. 

I also read that PSA has a half life of 2 to 3 days, so any spikes will take circa 14 days to get to 2% of a baseline. Therefore, for the next PSA test I'm going hide the bike and be a complete couch potato for 2 weeks beforehand and see what it brings! 

Maybe a week or more out of the gym or hard running before the next test would lower the PSA trend? 

Also, always get blood taken in the early morning so sample gets sent away and tested the same day. I had a scare having a late Friday afternoon test that came back at nearly 12 - until the Doc rang me a few days later to say disregard it as delay in testing create false positives - and did a re-test a week later that came in at half that.

I know how unsettling each PSA uptick can be, but recording the trends and getting it into context has been helpful for me and as time has progressed more comfortable with AS as a strategy.

Hope your PSA levels since May have normalised into a comfortable place, and good luck!

Cheers

Gi

Edited by member 06 Oct 2026 at 09:13  | Reason: Not specified

User
Posted 06 Oct 2026 at 13:11

Hi Gi,

Many thanks for responding.

I have been tracking and graphing my psa / trend since 2015 (when my brother was diagnosed).  It was fine initially until it then started to track upwards a few years ago.  It has since peaked at 7.8 before dropping back now to 6.8 (although now creeping back up).

I was diagnosed 2 years ago now but with a Gleason score of 6 and told it was low risk.  While that sounds good, my brother’s psa was only around 10 when he was diagnosed stage 4 so slightly paranoid about this.

Both MRI’s have been clear to date, no lesions and it was the biopsy that picked up the cancer.

The psa is not consistent and appears to go up and down for no obvious reason.  I used to cycle a fair bit but since retirement not so much as I regularly cycled as part of my commute.  I am a keen runner and have run 23 marathons / ultramarathons in the past 10 years but an ankle operation 2 years ago has slowed me down.  At the moment my main focus is strength training in the gym and injury recovery to get back to the ultra running 🤞🤞

The psa is up and down and not consistent but for now looks to be staying around 7 (average) although I also track if increasing > 0.75pa.

Key will be the next MRI as you say and due next Oct unless psa suddenly creeps up again.

Thank you again for your message and will keep tracking the trend. 

Regards

Richard

Edited by member 06 Oct 2026 at 13:16  | Reason: Not specified

User
Posted 06 Oct 2026 at 15:00

Not sure if I missed some of this ....

Have you had any HT or are they just checking your PSA 3 monthly...

 

Thanks

User
Posted 06 Oct 2026 at 18:44

Hi there,

I have been getting 3 monthly psa checks for the past 3 years now and have had 2 MRI scans and a biopsy but no other treatment (other than Tamsulosin).

Regards

Richard

 
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