Understanding Prostate Cancer Symptoms
A raised PSA level can understandably cause concern, particularly as PSA testing is often associated with prostate cancer. However, there are several reasons why PSA levels may increase, and many are not related to cancer.
Understanding what can affect your PSA result is important, as it can help determine whether further investigation is needed.
What Is PSA and Why Do Levels Rise?
Prostate-specific antigen (PSA) is a protein produced by the prostate gland, a small gland located below the bladder.
A PSA blood test measures the amount of this protein in your bloodstream. While small amounts of PSA are normally present in the blood, certain conditions or activities can cause levels to rise.
An elevated PSA level does not automatically mean prostate cancer is present. Your age, medical history, symptoms and previous test results all help determine what a raised result may mean.
What Are the Common Causes of a Raised PSA?
Several factors can contribute to a high PSA result, ranging from common prostate conditions to temporary changes caused by everyday activities.
1. Enlarged Prostate (BPH)
Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that becomes increasingly common with age.
As the prostate grows, it produces more PSA, which can lead to higher levels in the blood.
BPH may also cause urinary symptoms, including:
- Difficulty starting urination
- A weak urine stream
- Needing to urinate more frequently
- Waking during the night to pass urine
Although BPH is not prostate cancer, these symptoms should be assessed to identify the underlying cause.
2. Prostatitis and Urinary Infections
Inflammation of the prostate, known as prostatitis, can cause PSA levels to increase.
This may be linked to a bacterial infection or other forms of inflammation. Urinary tract infections can also affect PSA results.
Symptoms may include discomfort when urinating, pelvic pain, increased urinary frequency or fever.
PSA levels can remain raised for some time after an infection. Your doctor may therefore recommend waiting until the infection has resolved before repeating the test.
3. Recent Ejaculation or Vigorous Exercise
Certain activities can temporarily increase PSA levels, even when the prostate is otherwise healthy.
These include:
- Ejaculation within 48 hours of testing
- Vigorous exercise
- Cycling, particularly over longer distances
To help ensure an accurate result, patients are generally advised to avoid these activities for 48 hours before a PSA test.
4. Recent Medical Procedures
Some medical procedures involving the prostate or urinary tract can temporarily affect PSA levels.
These may include a prostate biopsy, urinary catheterisation or other procedures that cause irritation or inflammation.
If you have recently undergone treatment or investigation, it is important to inform your doctor before having a PSA blood test.
5. Prostate Cancer
Prostate cancer is another possible cause of raised PSA levels.
Cancerous cells within the prostate can produce PSA, leading to an increase in the amount detected in the blood.
However, not everyone with an elevated PSA level has prostate cancer, and some men diagnosed with prostate cancer may have PSA levels within the expected range.
This is why PSA testing alone cannot confirm or rule out cancer.
Does a Higher PSA Mean a Greater Risk of Prostate Cancer?
A higher PSA result can increase concern about prostate cancer, but there is no single PSA level that confirms a diagnosis.
The risk of prostate cancer depends on several factors, including:
- Age and general health
- Family history of prostate cancer
- Previous PSA results
- Prostate size
- Changes in PSA levels over time
Men with a family history of prostate cancer may have a higher risk and could benefit from discussing testing with their GP or a urology specialist.
Rather than focusing on one result, your doctor will consider your overall risk and whether additional tests are appropriate.
What Happens If Your PSA Is Raised?
If your PSA level is higher than expected, the next step is not necessarily a prostate biopsy.
Your doctor may initially recommend repeating the blood test, particularly if there is a possible temporary cause for the increase.
Depending on your results and medical history, further assessment may involve:
- Repeat PSA testing: To establish whether the level remains elevated or has changed.
- Digital rectal examination To check for abnormalities in the prostate gland.
- Prostate MRI: To identify areas that may require further investigation.
- Prostate biopsy: To examine tissue samples for cancerous cells if clinically indicated.
These investigations can help detect prostate cancer or identify other prostate conditions that may explain the raised result.
When Should You Seek Medical Advice?
If you have received a raised PSA result, it is important to discuss it with a healthcare professional rather than assume the worst.
You should also seek advice if you experience persistent urinary symptoms, blood in your urine or other changes affecting your prostate health.
Early assessment can help identify the cause and ensure that any necessary treatment or monitoring begins at the appropriate time.
Raised PSA Assessment with Dr Edward Calleja
Dr Edward Calleja is a Consultant Urological Surgeon specialising in prostate conditions and prostate cancer diagnosis and treatment.
He provides specialist assessment for patients with raised PSA levels, helping them understand their results and whether further investigations are needed.
Whether you have recently received an elevated PSA result, noticed changes in previous tests or have concerns due to a family history of prostate cancer, Dr Calleja can offer personalised advice based on your circumstances.
He supports private and NHS patients across Sussex, Kent and London, with online consultations also available.
To arrange a consultation, use the online booking system or contact Dr Calleja's secretary on 01424 757 458.
