Elevated PSA Levels: Causes and Next Steps for Patients

Q: Elevated PSA Levels: Causes and Next Steps for Patients

Hello： Inflammation can cause an increase in PSA levels, but it will gradually decrease over time and should be monitored until it returns to normal. <br>There are many lifestyle precautions to consider for prostatitis, and it is essential to adhere to them as much as possible to

Please inquire about elevated PSA levels?

Hello, Dr.
Du:
I would like to ask for your advice.
About a week ago, I experienced a sudden onset of symptoms for approximately three to four days, including a feeling of incomplete bladder emptying, a burning sensation in the urethra during and after urination, and slight discomfort in the perineal area.
I kept a urinary diary for four days, noting an intake of about 2500 cc of fluids and a urine output of approximately 1500-1800 cc daily.
During this time, I also visited a regional teaching hospital's urology department, where I underwent urinalysis and a PSA test.
I was prescribed Alfuzosin 0.4 mg, which I have taken for four days.
Today, I completed a digital rectal examination and a transrectal ultrasound, which showed no abnormalities, only a slightly enlarged prostate estimated at about 25 grams.
However, my PSA level from a blood test conducted a week ago was 12.
I have annual health check-ups, and over the past five years, my PSA levels have ranged from 0.7 to 0.9, with the most recent test being exactly one year ago.
The doctor explained that the elevated PSA might have been influenced by inflammation during the time of my symptoms, and suggested rechecking the PSA in three months for further evaluation.
No medication was prescribed, but as of today, the aforementioned symptoms have almost completely resolved, and my urination has returned to normal.
I have not experienced any other significant discomfort, and this is the first time I have had such sudden urinary tract symptoms.
However, I tend to be an anxious person, and I am concerned about the significance of the sudden increase in my PSA level.
Additionally, prior to these urinary symptoms, I had been engaging in masturbation approximately every 2-3 days, and the onset of my urinary discomfort coincided with the timing of my last masturbation.
Does this mean I should consider abstaining for a longer period? I also tend to stay up late frequently.
Should I seek a second opinion from a larger hospital? Thank you, Dr.
Du!

Ping An, 30~39 year old female. Ask Date: 2020/04/09

Dr. Du Shixi reply Urology

Hello: Inflammation can cause an increase in PSA levels, but it will gradually decrease over time and should be monitored until it returns to normal.
There are many lifestyle precautions to consider for prostatitis, and it is essential to adhere to them as much as possible to prevent recurrence.
Regarding abstinence, it is not necessarily required, but engaging in sexual activity 2-3 times a day may be excessive.
Additionally, safe sex practices should be followed.
For more information, you can refer to http://www.shutien.org.tw/dr_doc_detail.aspx?bookid=60.
Wishing you good health.

Reply Date: 2020/04/09

More Info

Elevated PSA (Prostate-Specific Antigen) levels can be concerning for many men, especially when there is a sudden spike from a historically stable range. In your case, the PSA level of 12 ng/mL is significantly higher than your previous readings of 0.7-0.9 ng/mL over the past five years. This sudden increase, coupled with your urinary symptoms, raises valid concerns that need to be addressed.

Causes of Elevated PSA Levels
1. Prostatitis: Inflammation of the prostate gland, which can be acute or chronic, is one of the most common causes of elevated PSA levels. Your recent urinary symptoms, including difficulty urinating and a burning sensation, suggest that prostatitis could be a contributing factor. The inflammation can lead to a temporary increase in PSA levels, which may return to normal once the inflammation resolves.

2. Benign Prostatic Hyperplasia (BPH): This non-cancerous enlargement of the prostate is common in older men and can also cause elevated PSA levels. While your prostate size was noted to be slightly enlarged at 25g, this is not necessarily indicative of cancer.

3. Prostate Cancer: Although a significant concern, prostate cancer typically does not cause such rapid fluctuations in PSA levels. However, it is essential to rule it out, especially given the elevated PSA level.

4. Recent Sexual Activity: Activities such as ejaculation can temporarily raise PSA levels. Since you mentioned engaging in sexual activity shortly before the symptoms began, this could have influenced your PSA results.

5. Other Factors: Recent medical procedures, urinary tract infections, or even certain medications can also affect PSA levels.

Next Steps
Given your situation, the recommendation to wait three months and then retest your PSA is a common approach. This allows time for any inflammation to subside and provides a clearer picture of your prostate health. Here are some additional considerations:
- Follow-Up Testing: After three months, if your PSA levels remain elevated, further testing may be warranted. This could include a prostate biopsy, especially if there are other concerning signs or if the PSA continues to rise.

- Lifestyle Modifications: While there is no specific diet that has been proven to lower PSA levels, maintaining a healthy lifestyle can benefit overall prostate health. This includes regular exercise, a balanced diet rich in fruits and vegetables, and staying hydrated. Reducing alcohol and caffeine intake may also help alleviate urinary symptoms.

- Managing Anxiety: Since you mentioned being prone to anxiety, it may be beneficial to seek support for managing stress. Anxiety can exacerbate physical symptoms and may lead to increased focus on bodily sensations, which can be distressing.

- Second Opinion: If you remain concerned about your PSA levels or if your symptoms return, seeking a second opinion from a urologist at a larger medical facility can provide additional reassurance and options for management.

Conclusion
In summary, while an elevated PSA level can be alarming, it is essential to consider the context of your symptoms and medical history. Prostatitis is a likely cause of your elevated PSA, especially given the recent urinary symptoms. Monitoring your PSA levels over the next few months, along with lifestyle adjustments and possibly seeking a second opinion, will help you navigate this situation effectively. Remember, communication with your healthcare provider is key to understanding your health and making informed decisions.

Similar Q&A

Understanding Elevated PSA Levels: Causes, Concerns, and Next Steps

Hello, Doctor: Q1. In April of this year, I had a health check-up, and my PSA level was 7.96. In May, I went to the hospital for further testing, and my PSA level was 7.92. Initially, the doctor only performed a blood test, but later I researched online and found that (1) acute ...

Dr. Xu Weikai reply Urology
Hello, 1. Elevated PSA levels can have many causes. However, your levels are quite high, and further examination is necessary, such as a prostate ultrasound and prostate biopsy. 2. Turbidity, leukocytes, nitrite, WBC, and RBC levels are all normal, which indicates no evidence...

Understanding Elevated PSA Levels: Causes and Concerns

My prostate-specific antigen (PSA) levels have been steadily increasing over the years, and last week it reached 30. I have undergone four biopsies at Asia University Hospital, all of which were normal. However, the continuous rise in this index is concerning. The doctor mentione...

Dr. Li Minghui reply Urology
Hello: A rise to 30 can be primarily attributed to inflammation or cancer. If you are open to it, I recommend seeking a second opinion at a medical center, as some physicians are more specialized in this area. Wishing you good health.

Understanding Elevated PSA Levels: Is It Prostate Cancer?

Recently, I visited a urologist due to urinary issues. In addition to a digital rectal exam, my PSA level was measured and found to be in the sixties. The doctor prescribed antibiotics, and after taking them, my urinary flow improved. The doctor recommended a follow-up appointmen...

Dr. Fu Shizhang reply Urology
There are many reasons for elevated PSA levels, with cancer, inflammation, and benign prostatic hyperplasia being common causes. A definitive diagnosis requires a prostate biopsy. Generally, if PSA levels are high but digital rectal examination and ultrasound imaging show no abno...

Understanding Elevated PSA Levels and Prostate Cancer Treatment Options

Hello Doctor: My father is 70 years old. At the end of last year, he was referred to a major hospital due to elevated PSA levels and urinary difficulties detected at a clinic. The physician recommended laser surgery to treat benign prostatic hyperplasia (BPH) and also performed c...

Dr. Jian Weihong reply Urology
Hello: 1. The PSA level has been elevated for over two months following surgery. Although surgery and inflammation can cause an increase, it should ideally decrease. If inflammation is present, it should be well-controlled. Additionally, what is the current assessment of the tu...