My friend 58 had rectal cancer was treated with chemo and radiation 2 years later just been told psa count 33 is this cancer?

See answer: 3 prostate conditions associated with an elevated prostate specific antigen (PSA): a benign enlarged prostate (BPH); prostate cancer (PCa), and prostate infection or inflammation (prostatitis). In the absence of an acute prostate infection, a PSA value of 33 ng/ml would be associated with a high risk of PCa: >50%. An abnormal digital rectal exam would increase suspicion. Prostate biopsy indicated.

Possibly: There are many sources of an elevated PSA. A PSA of 33 is concerning for prostate cancer, but (by itself) it is not diagnostic. Your friend needs to see a urologist ASAP for appropriate evaluation and testing.

Second test might : Be needed, it really depends on various factors beside age and history of cancer, your doctor should suggest another psa test , to confirm.