What Causes An Elevated Psa Level
The blood PSA level is typically elevated in men with prostate cancer. Therefore, the test is usually ordered in conjunction with the digital rectal exam to screen men that are asymptomatic for prostate cancer. It is also recommended for monitoring the progression of prostate cancer in men already diagnosed with the disease, and to test men with prostate symptoms to find out the nature of their problem.
Apart from prostate cancer, there are a number of conditions that may increase the PSA level. For instance, PSA is elevated with age, usually due to enlargement of prostate tissue over the years. Prostatitis , which is a condition common in men under 50 years due to bacterial infection, tends to result in increased PSA level. Other conditions that lead to increased PSA level include benign prostatic hyperplasia , urinary tract infections, prostate injury, recent ejaculation, high parathyroid hormone, and surgical procedures.
Why Is This Relevant
It matters because chronic prostatitis can also cause a set of symptoms and painful defecation is one of them. Some men with prostatitis also have irritable bowel syndrome.
While prostate size itself is not the common factor for problems with bowel movements, in some cases, it can happen.
Besides chronic or acute prostatitis, other BPH-related complications can also affect bowel movements. One of those complications is chronic urinary retention. Although rare, this complication can lead to large bowel obstruction.
You see, a common symptom of enlarged prostate is the inability to empty the bladder completely. When left untreated, this symptom leads to urinary retention.
In turn, urinary retention may lead to compression of the sigmoid colon against the sacrum . As a result, large bowel obstruction may occur. Considered a medical emergency, large bowel obstruction is a blockage that prevents the passing of food and liquid.
In other words, certain complications of BPH may impair bowel movements and lead to a medical emergency.
Besides the abovementioned complications, its also useful to mention that prostate enlargement can contribute to constipation. An enlarged prostate can form too much pressure on the rectum, making it difficult to defecate.
In addition to BPH, other prostate problems can act on the bowels too. A good example is prostate cancer or tumor, which may cause disruptions such as bowel incontinence or fecal incontinence.
Ejaculation Is A Potential Cause Of Mildly Elevated Psa
“Ejaculation can cause a mild elevation of your PSA level, and so can having a digital rectal exam,” says Milner. “These types of PSA elevations are usually not enough to make a significant difference unless your PSA is borderline. PSA should return to normal in two to three days.”
To avoid this type of elevation, doctors will usually draw blood for a person’s PSA level before doing a rectal exam. Ask your doctor if you should avoid ejaculation for a few days before a PSA test.
You May Like: Vinegar For Urinary Tract Infection
Who Can Have A Psa Test
If you are a man, trans woman, or a binary individual assigned male at birth, and over the age of 50, you can talk to your doctor about having a PSA test. You may be offered a PSA test as part of a general health check.
You can also talk to your doctor about having a PSA test if you are under 50 but have risk factors that are known to increase the chance of developing prostate cancer.
You do not have to have a PSA test it is your choice. Some men choose not to have the test, while others want to rule out the possibility of prostate cancer. There is no right or wrong answer. You might find it helpful to discuss the possible advantages and disadvantages with your partner, family, friends, or prostate cancer support groups.
Risk factors: If you are over 45 years of age with a family history of prostate cancer, of African descent, or have a known family history of a faulty gene called BRCA2, then you have a higher risk of developing prostate cancer.
Understanding Psa Test Results
28 August 2020
Medicare data suggests that up to 21% of Australian men aged 4574 choose to have a Prostate Specific Antigen Test each year, and about 19% of men aged over 74 also undergo testing.
While PSA testing helps to identify men with an increased risk of undiagnosed prostate cancer, and can help to diagnose prostate cancers earlier, it can also produce false positive results, and in some men picks up cancers that are so slow growing that they do not affect a mans life expectancy, a finding known as over-diagnosis. False positives and over-diagnosis can cause harm, which means men and their doctors need to carefully consider the pros and cons of testing, based on each mans age and other individual characteristics.
For men with no family history of prostate cancer and no symptoms, the current guidelines recommend that men who decide to undergo regular testing should be offered PSA testing every two years from age 50 to 69.
For men with a family history of prostate cancer who decide to undergo testing, the guidelines recommend men be offered PSA testing every two years from age 40/45 to 69, with the starting age depending on the strength of their family history.
Learn more here >
What is PSA?
Prostate Specific Antigen is a protein made in the prostate gland. The prostate is a walnut-sized gland that sits below the bladder in front of the rectum. It surrounds the urethra, the passage in the penis through which urine and semen pass.
Don’t Miss: What Causes Urinary Incontinence At Night
Age Specific Psa Reference Range
Because PSA tends to rise with age, an age-specific PSA reference range was proposed.
Age 40 49: normal PSA < 2.5
Age 50 59: normal PSA < 3.5
Age 60 69: normal PSA < 4.5
Age 70 79: normal PSA < 6.5
There are concerns that the original study was done primarily on white men, and did not take into account racial or ethnic backgrounds. It may also lead to missing or delaying the detection of prostate cancer in as many as 20% of men in their 60s and 60% of men in their 70s.
What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- What type of prostatitis do I have?
- What is the best treatment for this type of prostatitis?
- What are the treatment risks and side effects?
- How can I avoid getting prostatitis again?
- What type of follow-up care do I need after treatment?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Prostatitis is a common problem that affects many men. Unfortunately, theres a lot of confusion about the disease. People use the word prostatitis to describe four different conditions. There isnt a one-size-fits-all treatment for prostatitis, which is why an accurate diagnosis is so important.
What Is The Controversy Surrounding Psa Screening
Using the PSA test to screen for prostate cancer may help to detect small tumors. But many of these tumors do not cause symptoms and will grow so slowly that they are unlikely to be life-threatening.
Overtreatment exposes us to potential complications and adverse effects. These include the inability to control urine flow, and loss of erections.
Another controversy surrounding prostate cancer screening, using the PSA test, is that it may give false-positive or false-negative results for prostate cancer. What that means is you may have an elevated PSA level, but no cancer is actually present.
A false-positive test result will only cause anxiety for you and your family and might lead to unnecessary medical procedures.
One study reveals that only about 25 percent of men who have a biopsy due to a high PSA level have prostate cancer. Consider this before the doctor opens up your prostate.
A false-negative PSA test result can also occur. PSA levels can be low even though you actually have prostate cancer. False-negative test results may give you false assurance.
So to sum up:
- High PSA levels do not always mean that you have prostate cancer.
- There are many factors to consider, along with your family history, to see how likely you are to have cancer.
- And if your doctor recommends that you have a biopsy, you need to know all the risk factors involved.
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.
Don’t Miss: Lower Back Pain Causing Urinary Problems
What Are The Types Of Prostatitis
Types of prostatitis include:
- Acute bacterial prostatitis : A UTI causes an infection in the prostate gland. Symptoms include fever and chills. You may experience painful and frequent urination or have trouble urinating. Acute bacterial prostatitis requires immediate medical treatment.
- Chronic bacterial prostatitis : Bacteria become trapped in the prostate gland, causing recurrent UTIs that are difficult to treat.
- Chronic pelvic pain syndrome, or CPPS : CPPS is the most common prostatitis type. Prostate gland inflammation occurs in approximately 1 out of 3 men. As the name implies, this type causes chronic pain in the pelvis, perineum and genitals.
- Asymptomatic inflammatory prostatitis : This condition causes prostate gland inflammation but no symptoms. You may learn you have this condition after getting tests to find the cause of other problems. For example, a semen analysis for infertility may detect asymptomatic inflammatory prostatitis. This type doesnt need treatment.
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.
Recommended Reading: What Can You Do For Urinary Incontinence
Psa And Prostate Cancer: What Do My Numbers Mean
The prostateis a walnut-sized gland that sits below the bladder in men. It is responsible for creating semen, the milky liquid that carries sperm out of the body when a man ejaculates.
A PSA test is a blood test used to screen for prostate cancers. PSA is a protein produced in the prostate by both cancerous and noncancerous tissue. Elevated PSA levels can indicate the presence of cancer, but high PSA levels can also be a result of non-cancerous conditions like benign prostatic hyperplasia , or an infection. PSA levels also rise naturally as you age.
Elevated PSA levels do not necessarily mean that you have prostate cancer. PSA tests arent always accurate: many men who have prostate cancer have normal PSA levels. Alternatively, some men have high PSAs but dont have cancer. Or they have a slow growing form of cancer that would never have had symptoms or caused them any harm.
Recommended Reading: External Prostate Massage Prostatitis
Noncancerous Reasons For Elevated Psa
Prostatitis. Inflammation of the prostate gland, or prostatitis, can cause high PSA levels and is the most common prostate problem for men under 50. The bacterial form of prostatitis can be treated with antibiotics. Non-bacterial prostatitis is more difficult to treat.Benign Prostatic Hyperplasia . A non-cancerous enlargement of the prostate gland, BPH is a condition in which the gland is producing too many cells. This causes an increased level of PSA. Unless you are experiencing frequent or difficult urination, BPH likely will not require treatment. But your doctor should do a digital rectal exam to make sure the elevated PSA is due to BPH and not prostate cancer.Urinary Tract Infection . Any infection near the prostate gland, such as a UTI, can inflame prostate cells and cause your PSA levels to elevate. For this reason, its recommended that you do not get a PSA test until your UTI has been treated with antibiotics.The Urology specialists at Kelsey-Seybold Clinic in Houston can perform testing for PSA levels, and will provide you with valuable guidance prior to your appointment to avoid a false-positive result.
Read Also: How Do You Treat Urinary Incontinence
What Else Can Cause An Elevated Psa Besides Prostate Cancer
If you are a man in your 50s or older, you likely have a PSA drawn with your routine annual blood work. For men who receive an elevated PSA result, prostate cancer may be an immediate concern. However, prostate cancer is not the only condition that can cause the PSA to become elevated. Board-certified urologists Drs. Ahmad and Ali Kasraeian and the expert team at Kasraeian Urology in Jacksonville, FL have a deep understanding of the complex behavior of the PSA and carefully monitor patients PSA levels to identify any cause for concern. Learn more about PSA elevations here, including why other than prostate cancer your PSA may be high.
What Can Cause Psa To Rise Quickly
Sudden elevated PSA can be caused by prostatitis. Prostatitis is inflammation of the prostate. When the prostate is inflamed, it can be difficult or painful to urinate. If you have prostatitis, you may experience a persistent urge to urinate, wake up at night to urinate, or feel like you need to make frequent trips to the restroom. You may also have pain in the testicles or anorectal region or general pelvic discomfort. Chronic prostatitis is usually caused by autoimmune diseases, stress, and pelvic floor spasms. Urinary tract infections, bladder infections, urinary retention, and prostate stones usually cause bacterial prostatitis. Prostatitis is usually treated with antibiotics.
What Can Cause A High Psa Other Than Prostate Cancer
While prostate cancer is certainly a consideration when a patients PSA comes back high, it is not the only possible explanation. Besides prostate cancer, potential causes for an elevated PSA include:
- Infection: Prostatitis, urinary tract infection , and other infections involving the genitourinary tract can cause PSA elevations.
- Rectal exam: Because a digital rectal exam can cause a temporary PSA elevation, it is usually performed after the PSA has been drawn.
- Recent ejaculation: In some cases, ejaculating within 24 hours of a PSA test can cause the PSA to be elevated.
- BPH: Benign prostatic hyperplasia refers to an enlargement of the prostate gland. This condition is not cancerous or precancerous, though it can cause a number of signs and symptoms, including obstructed voiding and an elevated PSA.
- Trauma or surgery: Injury or manipulation of structures near the prostate and rectum, including surgical procedures, can cause the PSA to become elevated.
- Labile PSA: In some men, the PSA naturally rises and falls without an obvious inciting factor.
- Age: Most mens PSA levels rise gradually over time.
Common Causes Of Elevated Psa
Prostatitis. This also means a prostate infection, which causes inflammation of the prostate gland. Prostatitis is the most common prostate condition in men younger than 50. It can usually be treated with antibiotics.
Age. As men age, their prostate naturally gets bigger. This happens regardless of any medical condition affecting the prostate gland.
Benign Prostatic Hyperplasia . BPH also means an enlarged prostate gland. This does not mean prostate cancer. BPH is the most common prostate condition men over 50 suffer from. It can often cause urination problems such as frequent urination or difficulty urinating.
Prostate Cancer. An elevated PSA could indicate prostate cancer. If you have an elevated PSA, your doctor will also do a digital rectal exam to see if there are any suspicious lumps present on the prostate gland. If the doctor suspects prostate cancer, a prostate biopsy will be recommended.
Its also important to monitor any changes in the PSA. If the PSA continues to rise, this may mean prostate cancer. If you continue to have an elevated PSA, but your biopsy is negative, your doctor will most likely recommend follow-up PSA tests and a follow-up biopsy within six months.
Urinary Tract Infection. A urinary tract infection can cause irritation and inflammation in the prostate gland, which can cause the PSA to go up. If you have a UTI, a doctor will prescribe antibiotics to treat it.
What Abnormal Results Mean
A high PSA level has been linked to an increased chance of having prostate cancer.
PSA testing is an important tool for detecting prostate cancer, but it is not foolproof. Other conditions can cause a rise in PSA, including:
- A larger prostate
- Recent tests on your bladder or prostate
- Catheter tube recently placed into your bladder to drain urine
- Recent intercourse or ejaculation
Your provider will consider the following things when deciding on the next step:
- Your age
- If you had a PSA test in the past and how much and how fast your PSA level has changed
- If a prostate lump was found during your exam
- Other symptoms you may have
- Other risk factors for prostate cancer, such as ethnicity and family history
Men at high risk may need to have more tests. These may include:
- Repeating your PSA test, most often sometime within 3 months. You may receive treatment for a prostate infection first.
- A prostate biopsy will be done if the first PSA level is high, or if the level keeps rising when the PSA is measured again.
- A follow-up test called a free PSA . This measures the percentage of PSA in your blood that is not bound to other proteins. The lower the level of this test, the more likely it is that prostate cancer is present.
Other tests may also be done. The exact role of these tests in deciding on treatment is unclear.
- A urine test called PCA-3.
- An MRI of the prostate may help identify cancer in an area of the prostate that is hard to reach during a biopsy.