When To See A Doctor
Some of the first symptoms of patients who have an elevated PSA level is difficult or painful urination, pain in the abdomen or pelvic area, and a frequent urge to urinate. These symptoms can be signs of BPH, prostatitis, prostate cancer, and kidney stonesall of which require different treatment. If you are experiencing any of these symptoms, it is important to talk with your doctor. Your doctor will be able to help determine the cause of your problems and provide an individualized treatment plan.
What Does A High Psa Level Mean
High PSA levels could be a sign of prostate cancer or a different condition like prostatitis or an enlarged prostate.
Other things can affect your PSA level:
- Age. Your PSA will normally go up slowly as you get older, even if you have no prostate problems.
- Medications. Some drugs may affect blood PSA levels. Tell your doctor if youâre taking dutasteride or finasteride . These drugs may falsely lower PSA levels by half of what they should be.
If your PSA level is high, your doctor may suggest that you get a prostate biopsy to test for cancer.
How Is The Psa Test Used In Men Who Have Been Treated For Prostate Cancer
The PSA test is often used to monitor patients who have a history of prostate cancer to see if their cancer has recurred . If a mans PSA level begins to rise after prostate cancer treatment, it may be the first sign of a recurrence. Such a biochemical relapse typically appears months or years before other clinical signs and symptoms of prostate cancer recurrence.
However, a single elevated PSA measurement in a patient who has a history of prostate cancer does not always mean that the cancer has come back. A man who has been treated for prostate cancer should discuss an elevated PSA level with his doctor. The doctor may recommend repeating the PSA test or performing other tests to check for evidence of a recurrence. The doctor may look for a trend of rising PSA level over time rather than a single elevated PSA level.
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How Are Researchers Trying To Improve The Psa Test
Scientists are investigating ways to improve the PSA test to give doctors the ability to better distinguish cancerous from benign conditions and slow-growing cancers from fast-growing, potentially lethal cancers. None has been proven to decrease the risk of death from prostate cancer. Some of the methods being studied include:
What Does An Elevated Psa Level Mean If Ive Had Prostate Cancer In The Past
If youve ever had treatment for prostate cancer, youll have regular PSA screenings for the rest of your life. An increasing PSA level may mean the cancer has returned. Your care team may use other tests, including imaging scans and biopsies, to check for signs of cancer. If cancer returns, your team will discuss your treatment options with you.
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Other Reasons For An Elevated Psa Test
In addition to urinary tract infection and prostatitis, there are other reasons that can cause a high PSA level. These include:
- Benign prostatic hyperplasia Benign prostatic hyperplasia, also known as BPH, is enlargement of the prostate caused by aging. An enlarged prostate can produce higher levels of PSA. There are treatments available for BPH.
- Medical procedures A prostate exam or digital rectal exam can result in inflammation of the prostate and increased PSA levels. A urinary catheter or urethral scope can also cause higher PSA levels. For accurate results, wait a few weeks after having a medical procedure done before having a PSA test.
- Age It is normal for PSA levels to gradually trend up with age. If the rise in your PSA level is slow, and consistent with your age, there is likely no concern.
- Cancer An elevated PSA level does not mean you have cancer but most men with prostate cancer do have an elevated PSA level. If you have an elevated PSA level your doctor may perform a digital rectal exam to check for lumps on the prostate. They will also likely order another PSA test to see if your level continues to rise. They may order imaging tests to check for cancer on the prostate. If you are receiving treatment for prostate cancer, your doctor will likely monitor your PSA level to help determine how effective treatment is. If PSA decreases, it can indicate that treatment is effective.
What A High Psa Level Means If Its Not Prostate Cancer
A high PSA level can be the first sign of prostate cancer, but it can also be a sign of a less-serious condition. Find out why else you may have an abnormal PSA reading.
PSA tests measure a protein in your blood called prostate specific antigen. Prostate cancer makes PSA levels go higher, but a high PSA test result doesn’t always mean a man has prostate cancer.
Sometimes PSA readings are elevated because of something benign, such as ejaculating within 24 hours of the test, or because of a problem that needs treatment, such as a urinary tract infection, but that isnt cancer.
Because the test cant distinguish between serious causes of elevated PSA and other causes, the United States Preventive Services Task Force has historically recommended against prostate specific antigen testing in healthy men that is, men who have no family history, known risk factors, or symptoms of prostate cancer.
But in 2017 the USPSTF released new draft guidelines that encourage doctors to discuss the potential benefits and harms of using the PSA test to screen for cancer in men ages 55 to 69. The final recommendation statement is now being developed.
In the meantime, here are seven reasons, besides prostate cancer, your PSA level could be above normal.
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Factors That Might Affect Psa Levels
One reason its hard to use a set cutoff point with the PSA test when looking for prostate cancer is that a number of factors other than cancer can also affect PSA levels.
Factors that might raise PSA levels include:
- An enlarged prostate: Conditions such as benign prostatic hyperplasia, a non-cancerous enlargement of the prostate that affects many men as they grow older, can raise PSA levels.
- Older age: PSA levels normally go up slowly as you get older, even if you have no prostate abnormality.
- Prostatitis: This is an infection or inflammation of the prostate gland, which can raise PSA levels.
- Ejaculation: Thiscan make the PSA go up for a short time. This is why some doctors suggest that men abstain from ejaculation for a day or two before testing.
- Riding a bicycle: Some studies have suggested that cycling may raise PSA levels for a short time , although not all studies have found this.
- Certain urologic procedures: Some procedures done in a doctors office that affect the prostate, such as a prostate biopsy or cystoscopy, can raise PSA levels for a short time. Some studies have suggested that a digital rectal exam might raise PSA levels slightly, although other studies have not found this. Still, if both a PSA test and a DRE are being done during a doctor visit, some doctors advise having the blood drawn for the PSA before having the DRE, just in case.
- Certain medicines: Taking male hormones like testosterone may cause a rise in PSA.
Some things might lower PSA levels :
Psa Velocity: What Does A Quick Rise In Psa Mean
by Health Professional
Dear Dr. Greenstein:** My friend ,who is in his early 50s, just got the results of his annual PSA test – it was between 4-5. The results of his previous 6 annual tests were in the 1-2 range every year, until now. His brother recently had his prostate removed due to cancer.** He now has to see a specialist. We are both very concerned, but should we be that worried?
First, I never tell people to worry before we have all the answers. In this situation, it is crucial to know if this man has any new voiding problems such as burning, slow stream or the sensation he is not emptying his bladder. These symptoms can indicate prostate inflammation, which can falsely elevate the PSA value. In those cases, a course of antibiotics are warranted and the PSA can be repeated after finishing the antibiotics.
If the PSA normalizes then this man can continue to have his prostate examined every 6 – 12 months. The physical exam is also very important. The discovery of a nodule during the digital rectal exam raises the concern for an early developing prostate cancer. If this man has no symptoms, if the PSA does not normalize after antibiotics or if a nodule is felt, then it is clear his PSA is remaining high and prostate cancer must be ruled out.
It’s hard to tell people not to worry. I would rather they be concerned, stay optimistic, continue to follow-up with their physician and listen to what he or she has to say. Good luck.
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Natural Ways To Lower Psa Levels
If youre at risk for prostate cancer, or if your PSA levels are high, its very important to try to lower your PSA levels as much as possible. Fortunately, there are several natural ways to do that while also living a healthier life.
1. Stay leanCancer is more common in overweight and obese people. In fact, a recent study found a correlation between obesity and the risk of getting prostate cancer.
Why is there a connection? Obesity can impact the prostate and lead to things like altered sex hormones, inflammation of the prostate, and higher insulin levels. These issues can facilitate the growth of prostate cancer.
Obesity not only comes with an increased risk of prostate cancer, it can also increases the aggressiveness of prostate cancer. According to the Harvard Medical School, obese men were 2.2 times more likely to develop aggressive prostate cancer than lean men were each 22 pounds of excess weight boosted risk by 40%.
2. Exercise regularlyWe all know the value of exercise, but did you know that working out can help protect you from prostate cancer?
A study from the Harvard School of Public Health shows that men who engaged in long-term vigorous exercise had a 30% lower risk of developing advanced prostate cancer and 25% lower risk of developing lethal prostate cancer than those who did not.
But which exercise is best? A range of exercises qualified as vigorous under the study, including: swimming, working outside, general spots, and cycling
What Causes An Elevated Psa Level
Prostate cancer is the main cause of an elevated PSA level. But PSA levels increase with age and can reflect different prostate conditions. Other factors that may raise a persons PSA level include:
- Prostate enlargement and inflammation .
- Urinary tract infection.
- Urinary catheter placement.
Your healthcare provider will also consider whether your medications affect PSA levels. For example, 5-alpha reductase blockers treat enlarged prostates and will lower PSA levels.
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What Is A Psa Test
The PSA, which stands for prostate-specific antigen, is a specific enzyme produced by prostate cells in men. A PSA blood test measures the level of prostate-specific antigen in the patients blood at that given moment and is a valuable screening tool for the early detection of prostate cancer. Because the PSA can go up and down in response to a number of factors and conditions, it is important to monitor your level with regular PSA tests over time.
How To Lower Your Psa Level
Though you cannot control all the risks factors of the discussed prostate conditions, regular physical activity, healthy diet, and natural supplements can help you maintain a healthy prostate and overall wellbeing.
Lifestyle factors also play a role in aggressive prostate cancer following a prostate cancer diagnosis. Further, you can make positive choices to avoid the eventual radical prostate cancer treatment like such as radical prostatectomy.
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When Should I Start Getting My Psa Checked
Most men are encouraged to have regular PSA tests performed starting at around age 45, though men with a positive family history of prostate cancer or certain prostate cancer risk factors, such as being African American, should start sooner. During your initial visit with Dr. Kasraeian, he will thoroughly review your previous records, discuss your health history and family history, perform any necessary lab work or imaging studies, and formulate a customized care schedule that best meets your needs.
Urinary Tract Infection Or Irritation
An infection of the urinary tract, as well as irritation caused by medical procedures involving the urethra or bladder, may irritate the prostate and cause it to produce more PSA. If you have experienced any of these, be sure to let your doctor know. Youll need to give the area some time to heal and calm down before running a PSA test.
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It’s Important To Know Your Free Psa Level
The PSA molecule circulates throughout the body in two formseither bound to other proteins or unbound. The free PSA measures the unbound molecule and is often used by urologists as another helpful indicator for prostate cancer. The lower the percent of free PSA, the higher the risk of having prostate cancer. Patients with free PSA of less than 10 percent can have up to a 56 percent risk of harboring a focus of cancer in their prostates.
Medical Procedures Can Cause Psa To Rise
“Anything that traumatically interferes with the architecture around the prostate gland can make PSA go up,” says Dr. Milner. “One of the most common causes of significantly high PSA from this type of trauma is the placing of a catheter into the bladder.”
Another cause is a prostate or bladder exam that involves passing a scope or taking a biopsy.
“Since it takes about two to three days for PSA to go down by half, you should wait two to three weeks after this type of trauma to do a PSA test,” Milner says.
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What Are Psa Levels
Cells in the prostate gland produce PSA, and levels typically remain below 4 nanograms per milliliter .
Most individuals with prostate cancer have PSA levels above 4 ng/mL. However, some men with prostate cancer have a normal PSA level. Similarly, some men with a higher than average PSA do not have prostate cancer.
These variations mean that a PSA test alone cannot rule out or diagnose prostate cancer. However, the PSA test can identify whether a person has a higher risk of developing the disease.
Initial testing may include both a PSA test and a DRE.
During a DRE examination, a doctor inserts a finger into the rectum to check the prostate for anomalies.
If both of these tests suggest prostate cancer, then the doctor will arrange for a biopsy to confirm the diagnosis.
Repeating The Psa Test
A mans blood PSA level can vary over time , so some doctors recommend repeating the test after a month or so if the initial PSA result is abnormal. This is most likely to be a reasonable option if the PSA level is on the lower end of the borderline range . For higher PSA levels, doctors are more likely to recommend getting other tests, or going straight to a prostate biopsy.
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What Happens When The Prostate Enlarges
As the prostate enlarges, it presses against the urethra and interferes with urination. At the same time, the bladder wall becomes thicker and irritated, and begins to contract–even when it contains only small amounts of urine–which causes more frequent urination. And, as the bladder continues to weaken, it may not empty completely and leave some urine behind, leading to a frequent sensation of having to void, having a slow urinary flow, and waking up at night to urinate.
Blocking or narrowing of the urethra by the prostate and partial emptying of the bladder cause many of the problems associated with BPH.
What Do The Numbers Mean
PSA levels are measured as a number of nanograms in each milliliter of fluid tested. This is written as ng/mL.
- PSA level 2.5 ng/mL or lower: This is a normal PSA level for men under age 60, but in some cases, prostate cancer may still be present.
- PSA level between 2.5 and 4 ng/mL: This is a normal PSA level for most men.
- PSA level between 4 and 10 ng/mL: This indicates that prostate cancer might be present. At this level, there is about a 25% chance that you have prostate cancer.
- PSA level 10 ng/mL or above: There is a 50 percent chance that prostate cancer is present. The higher the PSA rises above 10 ng/mL, the greater the chance that you have prostate cancer.
Your doctor may also monitor your PSA velocity, or doubling time, which means recording your baseline PSA the level at your very first PSA test and seeing how fast the PSA level increases over time. Rapid increases in PSA readings can suggest cancer. If your PSA is slightly high, you and your doctor may decide to keep an eye on your levels on a regular basis to look for any change in the PSA velocity.
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What Is The Psa Test
Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a mans blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter of blood.
The blood level of PSA is often elevated in men with prostate cancer, and the PSA test was originally approved by the US Food and Drug Administration in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the use of the PSA test in conjunction with a digital rectal exam to test asymptomatic men for prostate cancer. Men who report prostate symptoms often undergo PSA testing to help doctors determine the nature of the problem.
In addition to prostate cancer, a number of benign conditions can cause a mans PSA level to rise. The most frequent benign prostate conditions that cause an elevation in PSA level are prostatitis and benign prostatic hyperplasia . There is no evidence that prostatitis or BPH leads to prostate cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.