Don’t panic even if your PSA rises

PSA is the name of a blood test used to find evidence of the possible presence of cancer of the prostate. Each of the letters in PSA stands for the first letter of each word in the phrase, “Prostatic Specific Antigen.”

We are concerned about PSA because a rise in the level of PSA may possibly indicate the start of such a cancer. So having your PSA checked once a year by your doctor is a good early warning system. Age 50 for Caucasians, and age 40 for Afro-Americans and all men with a family history of prostate cancer is a good age to start.

However, there are several other non-cancerous conditions, which may cause your PSA to rise, so just having an elevated PSA, while an important signal for you to seek further investigation of your PSA abnormality by a specialist in urology to be sure you don’t have cancer of the prostate does not by itself prove a diagnosis of prostate cancer.

Simple benign prostate enlargement, so common, as men get older, is frequently a non-cancerous cause of PSA elevation. This is because a benign prostate also produces PSA and the bigger the benignly enlarged prostate, the higher will be the PSA level.

A non-cancerous inflammation of the prostate, known as prostatitis is another very common cause of a rise in the PSA in the total absence of cancer. Prostatitis can cause symptoms varying in intensity from very severe, to barely noticeable or even completely absent. Appropriate antibiotic therapy can very often successfully be used to treat prostatitis resulting in a drop in the PSA to normal levels. Not every prostatitis however is caused by a bacterial infection that would respond to antibiotics; many are simply inflammations of the prostate in the absence of bacteria (germs) so it’s important to listen to the advice of your doctor.

The prostate gland like other parts of the body has blood vessels and these blood vessels can be affected as any other blood vessel in any other part of the body. So if an artery in the prostate gets clogged by atherosclerosis, the portion of the prostate dependant on that vessel for its blood supply will die and in the process, the PSA will rise. This condition is known as a prostate infarct and is akin to a “MI,” or Myocardial Infarction or “Heart Attack,” where a portion of the heart muscle gets cut off from its blood supply. Despite the rise in PSA, there is no cancer involved.

So there are a number of causes of PSA elevation, which are not related to cancer and it’s important for you not to get frantic if you’re told that your PSA is up. Just discuss it with your doctor and get a referral to a urologist.

Have a question? Call Dr. Okun at 718-241-6767.

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