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Cipro,elevated PSA,biopsy.Prostate cancer?

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General Surgeon
Practicing since : 1980
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HI I recently finished a 21 day course of cipro for an elevated psa of 4.46 which was discovered in May. The end result was an increase of my psa to over 5. I might add that I am 66 years old and less than a year ago my count was 2.9. I am to have a biopsy done in one weeks time. Does this signal that I have cancer?
Posted Sat, 5 May 2012 in Cancer
Answered by Dr. Rajinder Bajoria 39 minutes later

Thanks for your query.
At an age of 66 years rising level of prostate specific antigens is suggestive of prostatic disorder or prostate cancer in 35 % of people. As its predictive value is only 35%. Normal value is 4ng/ml. 97% of healthy male persons have significantly less PSA than 4ng/ml. Value of 4-10 ng/ml is considered unequivocal. Rise of more than 2 nano-gram /milliliter in one year is also suggestive to some extent prostatic disorder.

PSA can be increased by prostatitis, irritation, benign prostatic hyperplasia , and recent ejaculation, giving a false positive result.

Role of Cipro is only to treat prostatic infection. If rise in PSA is due to prostate infection it will come down. But in your case in spite of 21 day course of cipro PSA is rising ,so it rules out infection as the cause of rising PSA.

Hence my suggestion to you is that you need the following:

Digital rectal examination (DRE) has also been shown to produce an increase in PSA.

So to rule out or confirm malignancy best option is digital rectal examination , trans rectal ultrasound and biopsy of prostate gland.

PSA is present in small quantities in the serum of all men, with healthy prostates, but is often elevated in the presence of prostate cancer and in other prostate disorders.

"Complete investigation is desirable to rule out malignancy at this age".

‘Hope I have answered your query, I will be available to answer your follow up queries.

“Wish you Good Health and trouble free speedy recovery”


Above answer was peer-reviewed by
Follow-up: Cipro,elevated PSA,biopsy.Prostate cancer? 6 hours later
I forgot to mention that 11 months before my psa was 2.9. I see where you state that a dre can elevate the psa reading. My doctor did do a dre just before he had his nurse draw blood. This was after my course of cipro. So is it possible that this could have caused the reading to be elevated this much?
Answered by Dr. Rajinder Bajoria 11 hours later

Nice to see you again.     

Digital rectal examination causes only mild rise in PSA ,not to the extent seen in your case .

Rise in PSA definitely indicate prostatic pathology.

So further investigation to rule out any serious pathology is desirable.

Rise in PSA is not a 100% indicator of prostatic cancer.

‘Hope I have answered your query,

“Wish you Good Health and trouble free speedy recovery”

Above answer was peer-reviewed by
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