PSA is short for Prostate-Specific Antigen. It’s a protein produced by normal as well as malignant cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. The is sometimes elevated in men due to changes that come with age and changes in one's status of prostate health.
Prostate cancer or a number of benign (not cancerous) conditions can cause a man’s PSA level to rise. The most frequent benign prostate condition that cause an increase in PSA level is prostatitis, which is inflammation of the prostate and benign prostatic hyperplasia (BPH), which simply means enlargement of the prostate - which tends to occur in a large percentage of men over the age of 50.
Although you may feel the need to urinate more frequently with BPH or have painful urination or ejaculation with prostatitis, there is no evidence that either of these leads to prostate cancer. But it is possible for a man to have one or both of these conditions and develop prostate cancer as well.
What If levels Come Back High on PSA Screening Test?
When a man who has no symptoms of prostate cancer but is found to have an elevated PSA level, his doctor may recommend a second PSA test to confirm the original results were accurate.
If the PSA numbers come back still being high, his doctor may recommend to continue monitoring with PSA tests and may suggest digital rectal exams at regular intervals to watch for any changes over time.
In many cases where PSA numbers are elevated due to short term inflammation being present, PSA numbers go back down as the inflammation subsides. This is the more commonly seen scenario that plays out in most cases when high PSA numbers are discovered.
However, if a man’s PSA level continues to rise or if a suspicious lump is detected during a digital rectal exam, his doctor may then recommend additional tests to determine the nature of the problem. A urine test could also be recommended to check for a urinary tract infection. Last, it may be recommended to get imaging tests, such as an x-ray, transrectal or ultrasound.
If prostate cancer is suspected, the doctor will recommend a prostate biopsy to investigate further.
Does Testosterone Cause Prostate Cancer?
This has been one of those million dollar questions and one of debate for years. When thinking from an extremely simple layman’s point of view, there are a couple of viewpoints we can take.
DHT has been correlated with increasing the size of tissue growth in a man’s prostate. DHT comes from testosterone and therefore optimized levels of testosterone must bad for prostate and potentially contribute to prostate cancer then, right?
BUT, if thinking about this from another angle; Young men naturally have very high levels of testosterone but we don’t hear of a bunch of 20 something year old men with enlarged prostates or prostate cancer. In fact, we typically see it in older men with low testosterone. So, logic says we must question this assumed connection between testosterone and prostate cancer, yes?
Hmm… Many more questions to ask and many more still unanswered by science.
Whether testosterone replacement therapy (TRT) is safe for men with an already pre-existing history of prostate cancer is still an open question for debate and more studies are needed.
The existing evidence suggests that TRT may be safe for some men with low testosterone but who have slight elevations in PSA and who have successfully completed prostate cancer treatment and are at low risk for a reappearance of it. Or, simply for men suffering with low testosterone who have never had cancer and who have clearance of not currently having any.
What's a Normal Level of PSA?
There is no stern number or range etched in stone when it comes to what a man’s PSA level should be. Most medical professionals consider any PSA levels of 4.0/ng/ml or lower as normal though.
However, more recent studies have shown some men with PSA levels below 4.0 with having prostate cancer and others with levels above 4.0 without any prostate cancer.
As it pertains to reported normal PSA numbers; some drugs including finasteride and dutasteride which are used to treat BPH, can lower a man’s PSA level. This could also potentially hide or alter lab results on PSA numbers.
As it pertains to elevated PSA numbers, many variables can come into play and trigger this as mentioned before.
Summary
If a man’s PSA numbers are above 4.0 ng/ml, it is wise to investigate why and take any appropriate action from there. Sometimes, the answer is due to age or something fairly simple and benign. Always best however, to be safe and practice prevention and if necessary intervention, to support our health in the best way.
If you have any other questions about optimizing testosterone or other hormones if effort to look and feel your best, let us know how we may be able to assist you.
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Cheers to healthy prostates fellas,
Roger and The YOUTH-Rx team
Selected References:
- https://www.ncbi.nlm.nih.gov/pubmed/26779889
- https://www.ncbi.nlm.nih.gov/pubmed/15163773
- https://www.ncbi.nlm.nih.gov/pubmed/25621688
- https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/prostate-cancer-screening1?ds=1&s=prostate
- https://www.ncbi.nlm.nih.gov/pubmed/28212119
- https://www.ncbi.nlm.nih.gov/pubmed/19863857
