Did you get an elevated PSA (Prostate-Specific Antigen) test, and you immediately worried you may have a prostate cancer diagnosis? Don’t be too quick to jump to conclusions.
Elevated PSA levels are often associated with prostate cancer, but there are several non-cancerous conditions that can also cause an increase in PSA levels. In fact, for individuals with high levels of PSA, only 2% will have a form of prostate cancer requiring medical intervention. Some of the common causes for elevated PSA include age, prostatitis, benign prostatic hyperplasia, and urinary tract infections. Even having a medical procedure, recent ejaculation or prostate stimulation can increase PSA levels. Here’s a look at how ten common conditions can raise the PSA levels in men.
Benign Prostatic Hyperplasia (BPH): BPH, also commonly referred to as enlarged prostate, is a non-cancerous enlargement of the prostate gland, commonly seen in men as they age. As the prostate enlarges, it can release more PSA into the bloodstream, leading to elevated levels.
Prostatitis: Inflammation or infection of the prostate, known as prostatitis, can cause a temporary increase in PSA levels. This can be acute or chronic, and other symptoms like pain, fever, or difficulty urinating may be present.
Urinary Tract Infections (UTIs): A UTI in the prostate gland or the bladder can cause a rise in PSA levels because the infection can lead to inflammation or irritation of the prostate, thereby elevating the PSA.
Recent Ejaculation: Ejaculation can cause a temporary increase in PSA levels. In fact, oftentimes it is recommended to avoid sexual activity or ejaculation for 24-48 hours before a PSA test to prevent this effect.
Prostate Stimulation: Any physical manipulation of the prostate, such as during a digital rectal exam (DRE), a prostate biopsy, or other procedures, can temporarily increase PSA levels.
Age: PSA levels naturally increase with age, even in the absence of prostate cancer or other conditions. This is due to changes in the prostate gland that naturally occur with aging.
Recent Surgery or Medical Procedures: Any recent surgery or medical intervention involving the prostate, such as treatments for BPH or catheterization, can lead to elevated PSA levels due to irritation or trauma to the prostate tissue.
Exercise: Intense physical activity, especially cycling or activities that involve pressure on the prostate (such as heavy lifting), can sometimes cause temporary increases in PSA levels.
Medications: Certain medications, like 5-alpha reductase inhibitors (e.g., finasteride and dutasteride), which are used to treat BPH, can lower PSA levels, but in rare cases, they may have other effects on PSA interpretation. Some other medications may also alter PSA measurements.
Hematuria (Blood in the Urine): Blood in the urine can indicate inflammation or infection and that raises the PSA levels.
Elevated PSA levels do not generally cause any symptoms, so often a person may not know that they have elevated PSA levels until they receive routine screening for prostate cancer. Urologists consider a PSA above 3 as elevated for an individual aged between 50 and 69 years. A general guideline is that if PSA levels are between 4 and 10, there is approximately a 1 in 4 chance that this is due to prostate cancer.
Individuals should talk to their doctor about their risk of developing prostate cancer. They can discuss the benefits and risks of PSA screening, and their doctor will help them determine the best time to start based on their individual medical history. It’s important to consider the age, medical history, and other factors when interpreting PSA levels. An elevated PSA doesn’t automatically mean prostate cancer is present. If PSA is elevated, your doctor may recommend additional diagnostic tests (like a biopsy or imaging) to rule out cancer or other conditions.
