Re: PSA now 24
With psa's at those kind of levels, it's probably wise to get all the investigations you can. Although infections/inflammations certainly can raise the psa and also cause quite violent swings, there quite possibly may be an underlying element arising from a tumour, and it's best to be mentally prepared for the eventuality.
My own psa peaked at 20.8 a couple of years ago, following some major urological damage and ensuing procedures (bladder completely wrecked by massive acute retention/ prostate 60cc / permanent catheters and cystoscopies). When they eventually took biopsies during an op. for a couple of other things, a cancer was confirmed at Gleason 6 - most probably low grade - and the psa's then sagged into the range 11-13. Only recently have they gradually climbed back, to latest reading 14.8 .... and so far, I have opted against active treatment because the side effects would be both guaranteed and irrevocable in mycase - just managing the other stuff is quite enough.
I assume that you will so far have been seeing Urologists, and doubtless Oncologists also if your biopsies confirm a tumour. Those two professions often have very different views around treatment options, and it's not really a question of 'believing' them - much of what they say will be entirely factual - but deciding for yourself how to balance risks appropriate to your own life, so taking the best advice and information from as many different angles as you can. Definitely don't be railroaded into any particular course of action based on the last specialist you talked to - unless of course, their news is both dire and urgent. In most cases there is ample room for thinking time, before deciding which way to go....which might well include the 'Do-Nothing' options ('active surveillance' or 'watchful waiting' ) for a while, as the situation is monitored further.
I hope you manage to resolve your case before too long. Forums such as this can be an excellent means of obtaining a spread of case histories, opinion and advice. Could I also recommend the 'Prostate Cancer Charity Message Board' based here in the UK, which is generally acknowledged as a leader in the field - it is very easy to register, and there is a thriving long-term community of individuals always focused on the challenges of PCa (prostate cancer), and always eager to welcome new folk to the fold.
All the very best for now,
David (Aberdeenshire, Scotland)