Prostate Health: When to Worry About Cancer and PSA Levels

Q: Prostate Health: When to Worry About Cancer and PSA Levels

Hello, there are dozens of reasons that can cause an increase in PSA levels. <br>These include： prostatitis, constipation, sexual activity within 24 hours, diarrhea, prostate embolization, and an enlarged prostate, among others. <br>Note： If you're interested, you can look it up

I would like to hear suggestions?

Dr.
Hsu, I apologize for bothering you again.
I just noticed that you mentioned checking for the possibility of prostate cancer.
Did you mean to reassure me that, based on your experience, my age and condition suggest that the likelihood of prostate cancer is low and that there is no need for a check-up? It seems you suggested this because I might be worried.
Otherwise, based on my symptoms, it should just be a habitual issue with urination that is causing this problem, correct? Additionally, I would like to ask about the PSA test: a value of <4 is considered normal.
Besides the increase in age, particularly at 60 years old, where benign prostatic hyperplasia might cause values <6 to still be considered normal, what other reasons could lead to elevated PSA levels aside from the occurrence of prostate cancer?

aadda, 30~39 year old female. Ask Date: 2013/01/24

Dr. Xu Weikai reply Urology

Hello, there are dozens of reasons that can cause an increase in PSA levels.
These include: prostatitis, constipation, sexual activity within 24 hours, diarrhea, prostate embolization, and an enlarged prostate, among others.
Note: If you're interested, you can look it up online.
If you are truly concerned, you can undergo relevant prostate examinations.
Although prostate cancer primarily occurs in men over the age of 65, it can also occur in younger men.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Online responses should only be used as a reference; if necessary, you should seek medical attention at a healthcare facility.
This message is from Dr.
Hsu Wei-Kai, Chief of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2013/01/24

More Info

Understanding prostate health, particularly concerning PSA (Prostate-Specific Antigen) levels, is crucial for men, especially as they age. Your concerns about PSA levels and the potential for prostate cancer are valid, and it's important to clarify what these levels mean and the factors that can influence them.

Firstly, PSA is a protein produced by both normal and malignant cells of the prostate gland. A PSA level of less than 4 ng/mL is generally considered normal, but this threshold can vary based on age and individual risk factors. As you mentioned, PSA levels can rise with age due to benign conditions such as benign prostatic hyperplasia (BPH) or prostatitis (inflammation of the prostate). For instance, it's not uncommon for men over 60 to have PSA levels that are considered normal up to 6 ng/mL due to these benign conditions.

In your case, at 36 years old, a PSA level of 4.67 ng/mL, while slightly elevated, is not necessarily indicative of prostate cancer. Factors other than cancer that can cause elevated PSA levels include:
1. Benign Prostatic Hyperplasia (BPH): This non-cancerous enlargement of the prostate is common in older men and can lead to increased PSA levels.

2. Prostatitis: Inflammation or infection of the prostate can significantly elevate PSA levels. This can be acute or chronic and may present with symptoms such as pelvic pain or urinary difficulties.

3. Recent Sexual Activity: Engaging in sexual activity shortly before a PSA test can temporarily raise PSA levels. It’s generally recommended to avoid ejaculation for 24-48 hours before testing.

4. Medical Procedures: Any recent medical procedures involving the prostate, such as a digital rectal exam (DRE), prostate biopsy, or transrectal ultrasound, can also cause a temporary spike in PSA levels.

5. Urinary Tract Infections (UTIs): Infections in the urinary tract can influence PSA levels as well.

6. Cycling: Prolonged cycling can lead to increased pressure on the perineum, potentially affecting PSA levels.

Given your age and the context of your PSA levels, the likelihood of prostate cancer is relatively low. However, it’s essential to monitor these levels over time, especially if you notice any changes in urinary habits or if your PSA levels continue to rise. Regular check-ups with your healthcare provider can help establish a baseline and determine if further investigation is necessary.

If your PSA levels remain elevated or if you experience symptoms such as difficulty urinating, pain, or other concerning signs, your doctor may recommend further testing, including a repeat PSA test, free PSA test, or even a prostate biopsy if warranted. The free PSA test can help differentiate between benign conditions and prostate cancer, as lower percentages of free PSA are often associated with a higher risk of cancer.

In conclusion, while elevated PSA levels can be concerning, they do not automatically indicate prostate cancer, especially in younger men. It’s important to consider the broader context of your health, symptoms, and any potential benign causes for the elevation. Regular monitoring and open communication with your healthcare provider will be key in managing your prostate health and alleviating any anxiety you may have regarding cancer risk.

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