hello. welcome to HCM,
The PSA elevation is marked but what is more important is that PSA velocity (increase over time )is also high. Your foot swelling indicates another pathology (? gout
) which also needs investigation.
You need to get investigated thouroughly by TRANSRECTAL ULTRASOUND
to rule out malignancy. Otherwise PSA may also increase in benign enlargements and prostatitis
, though increase may not be that rapid.
so, please do not ignore, and get tested shortly.