Elevated PSA Level Causes
Prostate specific antigen (PSA) is a protein that is produced by the prostate gland. Rising levels of PSA in the bloodstream can be an early sign of prostate problems, including prostate cancer. But there are also many non-cancerous reasons for elevated PSA levels. Infection, inflammation, and injury can all trigger a rise in PSA.
Possible causes for elevated PSA level include:
- Benign prostatic hyperplasia (BPH). BPH is a common condition of prostate enlargement. As the prostate grows, it can press down on the urethra, causing lower urinary tract symptoms (or LUTS). Men with BPH may have difficulty urinating, problems with urinary urgency, and dribbling, among other symptoms.
The likelihood of developing BPH increases as men age. According to the American Urological Association, BPH affects about half of men in their fifties and sixties and up to 90% of men over age eighty. The larger the prostate, the greater the chance a PSA elevation may be due to a benign condition like BPH and not prostate cancer.
- Urinary tract infection (UTI). A UTI can also cause PSA to rise. However, your doctor can quickly rule out this condition with a simple urine test. UTIs can be effectively treated with antibiotics.
- Prostatitis. Prostatitis is the most common prostate issue in men under age fifty. Men with prostatitis have an irritated and inflamed (swollen) prostate gland. Symptoms include problems with urination and pain in the groin, abdomen, or lower back.
Treatment for prostatitis involves symptom relief through muscle relaxants, pain relievers, and massage. In some cases, prostatitis may be caused by a bacterial infection. Bacterial prostatitis can usually be treated effectively with antibiotics.
If you’ve had your PSA levels tested and the results have come back high, the odds are in your favor. Roughly 75% of men who have a prostate biopsy as a follow up to a high PSA end up having non-cancerous reasons for elevated PSA levels.
But if you are in the 75%, how can you avoid biopsy – which is an invasive procedure that has risks, costs, and side effects for the patient – if you don’t need it? Historically, men with high PSAs suspicious of prostate cancer have been sent directly for biopsy. But in recent years, new technology has made another non-invasive option a reality. Multiparametric magnetic resonance imaging, or mpMRI, creates a detailed picture of the prostate using sophisticated computer software. mpMRI has the advantage of accurately imaging the entire prostate (not just the twelve random samples of traditional TRUS biopsy). The imaging zeroes in on suspicious tumor tissue, or rules out a prostate cancer completely. Later, if a biopsy of suspicious areas is needed, it can be performed with an accurate “map” of the prostate.
Dr. Dan Sperling and the Sperling Prostate Center offers mpMRI diagnostic imaging of the prostate. Our state-of-the-art facility is equipped with the latest mpMRI software and a 3 Tesla (3T) magnet. Fill out our consultation form today to get more information.
 Barry MJ. Clinical practice. Prostate-specific-antigen testing for early diagnosis of prostate cancer. New England Journal of Medicine 2001;344(18):1373-1377.