By: John King
This month was Prostate Cancer Awareness Month. So you went to you doctor for an exam and a PSA blood test. If your PSA came back 1.0 ng/ml or less, congratulations on a perfectly healthy prostate! However, if you are one of the many men who’s PSA level is slightly to moderately elevated (above 1.0 and less that 4.0 ng/ml), not to worry, it doesn’t necessarily mean cancer!
There are many things that can contribute to an elevated PSA level beside having cancer. Think of PSA as a barometer of overall prostate health. If levels start to rise then it’s time to take action as something is going awry.
- Relative Prostate Volume – If you have a small prostate your PSA level may be slightly lower than the average. Likewise, if a normal healthy prostate is larger than the average, PSA will be higher.
- Sex – Ejaculation causes a temporary rise in PSA level. Additionally, having too much sex puts stress on the prostate gland causing irritation which will elevate PSA levels. I recommend waiting 72 hours after sexual activity before having your PSA test.
- Getting Older – Most urologists will tell you that a rising PSA is just a part of getting older. While that may be true to some degree, it doesn’t have to be the case. Getting enough exercise, following a healthy diet, monitoring and manipulating hormones as required as well as other holistic interventions go along way in preventing “PSA creep”.
- Bicycle Riding – Pressure on the perineum is transferred to the prostate and can cause an elevated PSA reading due to irritation. Any high intensity exercise that jars the pelvic area such as running, high impact sports training or horseback riding could potentially elevate your PSA temporarily. I would defer to my 72 hour rule and avoid these types of activity before your test.
- Groin Injury – Any type of groin injury such as a pulled muscle or impact to the groin area can elevate PSA levels. This could also include such things as a car accident, broken hip or pelvis.
- Having a DRE – The prostate is very sensitive, even the mild pressure applied to it during a Digital Rectal Exam can create an elevated PSA reading. So make sure your doctor draws your blood BEFORE your exam if you want an accurate reading.
- Catheterization or Surgery – Having any type of urinary tract surgery or catheterization will most certainly raise your PSA. How long this elevation exists depends on how much prostate trauma occurs. Having an elevated PSA for weeks or even months is possible.
- Biopsy – Having a prostate biopsy, like surgery, will raise PSA. Most urologists will tell you to allow six weeks for your PSA to return to normal after a biopsy. In all likelihood it will take longer than that, so don’t worry.
- Exogenous Chemicals – Foreign chemicals introduced to the body can affect PSA levels. They can be in the form of medications for an enlarged prostate, chemotherapy drugs, sports supplements, diet supplements or other over the counter medications.
- Prostatitis or Infection – Prostatitis (an inflammation of the prostate gland) will cause an elevated PSA. This could be non-bacterial prostatitis which is basically prostatitis with no identifiable cause. Or it could be due to a bacterial infection or less commonly a virus. If you have any type of infection it should be treated until your symptoms are resolved and PSA returns to normal.
- BPH – Benign Prostatic Hyperplasia is generally classified as a non-cancerous condition that causes the prostate gland to become enlarged. Since the prostate has a greater volume more PSA is produced. BPH can be a warning sign of things to come. Since this condition is caused by inflammation and/or hormone inbalances, it sets the stage for abnormal cell growth. Chronic conditions such as this respond well to holistic interventions.
- Heredity – Some men possess genes that predispose them to a naturally higher baseline PSA that can be 10% above what is considered normal. Only genetic testing can identify whether you have this gene.
There you have it, a dozen things that can raise PSA levels that’s not cancer. I have a couple of personal recommendations regarding PSA testing. First, always use the same lab. Depending on the testing method used PSA reading on the same blood sample can be different! Using the same laboratory every time ensures consistency. Second, pay strict attention to my 72 hour rule regarding exercise and sexual activity prior to PSA testing. Doing so will ensure consistency and provide a more accurate assessment of your prostate health.
If you were prompted to get your prostate checked this month and your number was not what you expected don’t jump to conclusions. Take time to investigate these potential causes for your elevated PSA as it may not be cancer at all. If you and your doctor decide that you require further testing take it one step at a time and look for my upcoming article Prostate Cancer Testing: Navigating The Maze.
Best in Health,