Thank you for your question. There seems to be several things packed into your question.
With respect to your PSA levels. A variation of 2.1 - 5.0 over a short period of time could be caused by varying degrees of BPH, prostatitis, and prostate cancer. Also, the differences could be caused by lab variation. Finally, if blood is drawn after a DRE is performed, this could also elevate the level of PSA in the bloodstream.
Age-specific PSA levels tend to underdiagnose, misdiagnose really, prostate cancer in men as they get older. Continued elevated PSA levels should move you in the direction of a prostate biopsy.
Thank you for your question.
Ash Tewari, MD
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Mike, first don't worry about the biopsy..I had one done a few months back..maybe little uncomfortable but really nothing. Went to lunch with my wife right after. My PSA is up and down also..went from 2.0 to 4.6..then they did a biopsy and I was diagnosed with cancer. Got two more opinions and those two said NO you do not have cancer but my PSA will need to be monitored. My last PSA a few weeks ago was 3.0. Please get more than one opinion...its crazy what you are told.