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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Elevated PSA Levels?

Dear Sir Can you comment on the above 3 + 4 and 4 +3 are both these gleason scores considered Aggressive ? Six months ago I had a 4kScore of 7 , i.e. low risk for aggressive prostate cancer. But my PSA continues to rise and since the 4kScore has gone from 5.3 to 7.4 with free PSA of 15.1%, in just 6 months. Two months ago I had a shot of cortisone to relieve arthritis pain. I have since discovered, cortisone can increase PSA - please see attached. In mid 2015 my PSA was 2.9. Warm Regards Dale Horstman
Mon, 5 Jun 2017
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General Surgeon,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

Yes, PSA levels may be affected by some medications including steroids but also it may indicate disease progression. You need to do bone scintigraphy to rule out prostate tumor spread.
It would be good to repeat PSA levels, 2 weeks after you took last steroid shot since by then this drug concentration should reduce to almost zero and then the test would be more reliable for interpretation.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Ivan R. Rommstein
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What Causes Elevated PSA Levels?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Yes, PSA levels may be affected by some medications including steroids but also it may indicate disease progression. You need to do bone scintigraphy to rule out prostate tumor spread. It would be good to repeat PSA levels, 2 weeks after you took last steroid shot since by then this drug concentration should reduce to almost zero and then the test would be more reliable for interpretation. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein