7 Causes Of High PSA Levels Without Prostate Cancer

PSA or prostatic specific antigen is a special protein that is secreted by prostate cells. The PSA test determines the serum levels of this protein in the blood. It has been observed that high PSA levels are usually suggestive of prostate disease but high levels of PSA doesn’t always mean that the person is suffering from prostate cancer. High PSA levels that are caused by benign conditions returns to normal levels if inciting source is removed.

What Should You Know About PSA Levels?

Under normal circumstances, the serum secretions of PSA should stay under 4 nanograms per milliliter (ng/mL). People who have prostate malignancy usually have high PSA levels, but low or normal PSA doesn’t always mean that the person is cancer-free. A smaller number of men with prostate cancer have low or normal PSA levels. This suggests that PSA test by itself is not a confirmatory test but can help in identifying who might be at risk of developing the cancer or has developed the malignancy.

Usually PSA test is preceded or coupled by DRE (digital rectal examination), in which the examiner inserts the finger in patient’s rectum to check for the consistency or edges of prostate gland. At risk patients with abnormal findings on the DRE and high PSA levels are subjected to biopsy to ascertain the cause and confirm the diagnosis. It is imperative to mention that False-Positives (high PSA levels without any presence of malignancy) are common.

High PSA Levels without Prostate Cancer:

Testing errors such as mishandling of sample, measuring inconsistency, lifestyle choices and overall physical health can alter with PSA levels. Following are some physiological causes of high PSA levels.

• Physiological Aging: PSA levels increases with advancing age. Men over 50 should speak to their doctor atregular intervals and should opt for PSA screening for early detection of prostate malignancy. Don’t forget to discuss other danger signs and symptoms of prostate cancer with your doctor. Some investigators advocate that PSA screening does not add any value or benefit and instead add more anxiety and increase the chances of over-treatment. If you are not at risk of developing prostate malignancy, routine screening can be delayed by 70 years of age.
• Prostatitis: Inflammation of prostate gland due to a bacterial infection can also present with high PSA levels. Prostatitis may be acute or chronic; symptomatic or asymptomatic. Common symptoms of prostatitis are; difficulty while urinating, feeling of pressure in the rectum, noticeable changes in the sexual functions (e.g. inability to ejaculate), fever etc.
• Benign Prostatic Hyperplasia: Also referred to as a BPH is a physiological condition that is seen in men with advancing age. However, it is not always problematic. Although it is not a precursor for cancer, it may present with symptoms that are suggestive of cancer such as trouble urinating, poor stream, feeling of incomplete urination etc.
• Urinary Tract Infection: Active infections of urinary tract region (bacterial growth in the region of bladder and urethra) can also present with high PSA levels. Suggestive symptoms of UTI are; painful urination, appearance of blood in the urine etc. History, physical examination and Urine (detailed report) can easily diagnose UTI.
• Medical Instrumentation Or Procedures: Instrumentation (such as insertion of a catheter) or any medical procedure involving the prostate gland such as biopsy, can present with high PSA levels. Doctors usually recommend waiting for at least 4-6 weeks after any instrumentation/ procedure to avoid the risk of false-positives.
• Strenuous Workout: Intensive workout or exercise can also elevate PSA levels.
• Ejaculation Or Masturbation: Avoid engaging in sexual contact or masturbation for at least 2-3 days prior to getting your PSA assessment as it may temporarily increase the PSA levels.

References:

• Cooper, C. P., Merritt, T. L., Ross, L. E., John, L. V., & Jorgensen, C. M. (2004). To screen or not to screen, when clinical guidelines disagree: primary care physicians' use of the PSA test. Preventive medicine, 38(2), 182-191.
• Carlsson, S., Aus, G., Wessman, C., & Hugosson, J. (2007). Anxiety associated with prostate cancer screening with special reference to men with a positive screening test (elevated PSA)–Results from a prospective, population-based, randomised study. European Journal of Cancer, 43(14), 2109-2116.