Elevated PSA (Elevated Prostate-Specific Antigen): Symptoms, Causes, Treatment

What are the symptoms of elevated PSA?

Elevated prostate-specific antigen (PSA) levels do not typically cause symptoms on their own. PSA is a protein produced by the prostate gland, and elevated levels can be a sign of prostate cancer, as well as other prostate conditions such as prostatitis (inflammation of the prostate) or benign prostatic hyperplasia (enlargement of the prostate).

However, if prostate cancer is present and has progressed, it may cause symptoms such as:

1. Urinary symptoms: These can include frequent urination, especially at night (nocturia), difficulty starting or maintaining a urine stream, weak urine stream, or a sensation of incomplete bladder emptying.
2. Blood in the urine or semen: This can manifest as pink, red, or brownish urine, or as blood in the semen.
3. Erectile dysfunction: Difficulty achieving or maintaining an erection.
4. Painful ejaculation: Discomfort or pain during ejaculation.
5. Pelvic discomfort: Pain or pressure in the pelvis, hips, or lower back.

It’s important to note that these symptoms can also be caused by conditions other than prostate cancer, and having these symptoms does not necessarily mean you have prostate cancer. If you have any concerns about your prostate health or are experiencing symptoms, it’s important to speak with a healthcare provider for an evaluation and appropriate management.

What are the causes of elevated PSA?

Elevated prostate-specific antigen (PSA) levels can be caused by a variety of factors, including benign (non-cancerous) conditions as well as prostate cancer. Here are some common causes of elevated PSA:

1. Benign prostatic hyperplasia (BPH): BPH is a non-cancerous enlargement of the prostate gland that is common in older men. BPH can cause PSA levels to rise, but does not increase the risk of prostate cancer.
2. Prostatitis: Prostatitis is inflammation of the prostate gland, often caused by infection. Acute or chronic prostatitis can cause PSA levels to rise.
3. Urinary tract infection (UTI): Infection in the urinary tract can cause inflammation in the prostate gland, leading to an increase in PSA levels.
4. Recent ejaculation: Ejaculation within 48 hours before a PSA test can cause temporary elevation of PSA levels.
5. Prostate biopsy or surgery: Any procedure that involves the prostate gland, such as a biopsy or surgery, can cause PSA levels to rise temporarily.
6. Catheterization: Having a urinary catheter inserted can cause irritation to the prostate gland and elevate PSA levels.
7. Age: PSA levels naturally increase with age, so older men may have higher PSA levels even in the absence of prostate cancer.
8. Medications: Certain medications, such as finasteride (Proscar) or dutasteride (Avodart), which are used to treat BPH, can lower PSA levels. Conversely, use of testosterone replacement therapy can raise PSA levels.
9. Vigorous exercise or physical activity: Intense physical activity, such as cycling, can temporarily increase PSA levels.

It’s important to note that while these factors can cause PSA levels to rise, an elevated PSA level does not necessarily mean that prostate cancer is present. Further testing, such as a digital rectal exam (DRE) or prostate biopsy, may be needed to determine the cause of the elevated PSA and whether further evaluation for prostate cancer is necessary.

If elevated PSA is caused by prostate cancer, what is the treatment?

If elevated prostate-specific antigen (PSA) levels are caused by prostate cancer, treatment options will depend on several factors, including the stage of the cancer, the aggressiveness of the cancer, the overall health of the patient, and the patient’s preferences. Treatment options for prostate cancer may include:

1. Active surveillance: For low-risk prostate cancer, especially in older men or those with other serious health conditions, active surveillance may be recommended. This involves regular monitoring of PSA levels, digital rectal exams, and possibly repeat biopsies to monitor the progression of the cancer. Treatment is only initiated if the cancer shows signs of progression.
2. Surgery: Surgical removal of the prostate gland, known as radical prostatectomy, may be recommended for younger men with localized prostate cancer. This procedure can be done using traditional open surgery or minimally invasive techniques such as laparoscopic or robotic-assisted surgery.
3. Radiation therapy: Radiation therapy uses high-energy beams to kill cancer cells. It can be delivered externally (external beam radiation therapy) or internally (brachytherapy). Radiation therapy may be used alone or in combination with other treatments.
4. Hormone therapy: Also known as androgen deprivation therapy (ADT), hormone therapy aims to reduce the levels of male hormones (androgens) in the body, which can help shrink or slow the growth of prostate cancer. Hormone therapy is often used in combination with other treatments for advanced or aggressive prostate cancer.
5. Chemotherapy: Chemotherapy uses drugs to kill cancer cells. It may be recommended for advanced prostate cancer that has spread to other parts of the body (metastatic prostate cancer).
6. Immunotherapy: Immunotherapy uses medications to stimulate the body’s immune system to recognize and attack cancer cells. It may be used in certain cases of advanced prostate cancer.
7. Targeted therapy: Targeted therapy targets specific molecules involved in cancer growth and progression. It may be used in combination with other treatments for advanced prostate cancer.

The choice of treatment depends on several factors and should be made in consultation with a healthcare provider who can provide personalized recommendations based on your specific situation.

What is the survival rate for prostate cancer?

The survival rate for prostate cancer varies depending on several factors, including the stage and grade of the cancer, the patient’s overall health, and the treatment options chosen.

According to the American Cancer Society, the 5-year survival rate for men with prostate cancer is:

• 99% for men whose cancer is confined to the prostate gland (Stage I or II)
• 93% for men whose cancer has spread to the seminal vesicles or lymph nodes (Stage III)
• 28% for men whose cancer has spread to other parts of the body (Stage IV)

The overall 5-year survival rate for men with prostate cancer is approximately 92%.

It’s important to note that these rates are based on data from studies of men diagnosed with prostate cancer in the past, and treatment options and outcomes have improved significantly over time. Many men with prostate cancer are now able to be treated with curative intent, meaning that they have a high chance of being cured of their cancer.

Factors that can affect the survival rate for prostate cancer include:

• Age: Men diagnosed with prostate cancer at an older age tend to have a better prognosis than those diagnosed at a younger age.
• Stage: Men with earlier-stage cancer (Stage I or II) have a better prognosis than those with more advanced disease (Stage III or IV).
• Grade: Men with higher-grade tumors (Gleason score 8-10) tend to have a worse prognosis than those with lower-grade tumors (Gleason score 2-7).
• PSA level: Men with a higher PSA level at diagnosis tend to have a worse prognosis than those with a lower PSA level.
• Treatment: Men who receive active surveillance or watchful waiting may have a poorer prognosis than those who receive definitive treatment such as surgery or radiation therapy.

It’s important to discuss individualized survival rates and treatment options with a healthcare provider.