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What Does Elevated PSA Level Indicate?
Question: Dear sir,
My father aged 73 has been tested for PSA level after having problems with urination. his psa level has been found to be 31.25 ng/ml. He was earlier having enlarged prostate twice- first time in Feb'11 and second time in July'14. Is this high level of PSA indication of prostate cancer or this is due to some other problems. please advise. His physician has written ultrasound test to further confirm the problem.
XXXXX
XXXXXXX
My father aged 73 has been tested for PSA level after having problems with urination. his psa level has been found to be 31.25 ng/ml. He was earlier having enlarged prostate twice- first time in Feb'11 and second time in July'14. Is this high level of PSA indication of prostate cancer or this is due to some other problems. please advise. His physician has written ultrasound test to further confirm the problem.
XXXXX
XXXXXXX
Brief Answer:
PSA level definitely indicates carcinoma.
Detailed Answer:
Hi XXXXXXX
Thanks for asking.
I am Dr. Jyothi BL and I will be answering your query.
Based on clinical history and query, my opinion is as follows:
1. PSA of more than 10 ng/ml signficantly points towards a diagnosis of prostatic cancer. Even though PSA is used basically for screening purpose, the high level at present is more consistent with carcinoma.
2. Even though PSA levels can elevated in prostatitis or urinary tract infections or after prostatic examination, the levels wont be so high. It will usually less than 10 ng/ ml or still less than 4 ng/ml
3. The present level is more in relation to prostatic carcinoma.
4. Ultrasound will help in detecting the size of the prostate and any lymphnode involvement or invasion in surrounding areas.
5. Earlier enlargements could have been benign prostatic hyperplasia. Now, based on PSA levels, I would strongly think of carcinoma.
6. Ultrasound followed by a prostate biopsy will confirm the diagnosis.
Hope it helps.
Any further queries, I am here to help again.
Take care.
Dr. Jyothi BL
PSA level definitely indicates carcinoma.
Detailed Answer:
Hi XXXXXXX
Thanks for asking.
I am Dr. Jyothi BL and I will be answering your query.
Based on clinical history and query, my opinion is as follows:
1. PSA of more than 10 ng/ml signficantly points towards a diagnosis of prostatic cancer. Even though PSA is used basically for screening purpose, the high level at present is more consistent with carcinoma.
2. Even though PSA levels can elevated in prostatitis or urinary tract infections or after prostatic examination, the levels wont be so high. It will usually less than 10 ng/ ml or still less than 4 ng/ml
3. The present level is more in relation to prostatic carcinoma.
4. Ultrasound will help in detecting the size of the prostate and any lymphnode involvement or invasion in surrounding areas.
5. Earlier enlargements could have been benign prostatic hyperplasia. Now, based on PSA levels, I would strongly think of carcinoma.
6. Ultrasound followed by a prostate biopsy will confirm the diagnosis.
Hope it helps.
Any further queries, I am here to help again.
Take care.
Dr. Jyothi BL
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you Doctor for your prompt advise. I was waiting for some tests which I have now. Please find attached test results. I am posting my queries as below-
PSA test was repeated and found to be -
Total PSA-15.2
Free PSA - 3.5
(earlier t psa was 31.5)
As advised, ultrasound was performed of which report is attached. This u/s shows almost same result found earlier in 2011 indicating enlarged prostate and elevated
PVRU. It is worth mentioning here that in 2011 also, on the basis of u/s report, Cantiflo D was administered for more than 6 months followed by Siladol which is continuing till date. No psr test was recommended at that time. Does this u/s result ( refer comment - no focal lesion) alone rule out possibilities of carcinoma. Is it necessary to go for biopsy or treatment of BPH is enough. I have heard that biopsy may trigger other problems also. Results of urine culture has also shown positive results with colony count >100000 colonies/ml.
Our physician has confirmed that drastic decrease in psa level indicates no cancer. Urologist has asked for review after 2 weeks with test of free psa and total psa.
please give your valuable opinion.
Thanks in advance.
regards
PSA test was repeated and found to be -
Total PSA-15.2
Free PSA - 3.5
(earlier t psa was 31.5)
As advised, ultrasound was performed of which report is attached. This u/s shows almost same result found earlier in 2011 indicating enlarged prostate and elevated
PVRU. It is worth mentioning here that in 2011 also, on the basis of u/s report, Cantiflo D was administered for more than 6 months followed by Siladol which is continuing till date. No psr test was recommended at that time. Does this u/s result ( refer comment - no focal lesion) alone rule out possibilities of carcinoma. Is it necessary to go for biopsy or treatment of BPH is enough. I have heard that biopsy may trigger other problems also. Results of urine culture has also shown positive results with colony count >100000 colonies/ml.
Our physician has confirmed that drastic decrease in psa level indicates no cancer. Urologist has asked for review after 2 weeks with test of free psa and total psa.
please give your valuable opinion.
Thanks in advance.
regards
Brief Answer:
Falling PSA- Low possibility of prostate cancer.
Detailed Answer:
Hi XXXXXXX
Thanks for asking again.
Reducing PSA level does indicate the reducing possibility of prostate cancer.
The earlier cause could have been due to prostatitis and antibiotic therapy could have improved it and hence, PSA level has probably fallen.
With enlarged prostate, repeated risk of urinary tract infection is always present due to urine being retained after voiding.
Followup with next PSA levels. If it is falling, then it is good.
The risk at present based on Total and free PSA is very low for prostate cancer.
If there is repeated urinary tract infection, getting transurethral resection of prostate surgery would be beneficial. If it becomes complicated, then surgery in critical conditions will be serious.
If the followup PSA levels are rising again, get a needle biopsy. Mild bleeding is possibly the major complication. Otherwise not much.
Hope it helps.
Any further queries, happy to help again.
Dr. Jyothi BL
Falling PSA- Low possibility of prostate cancer.
Detailed Answer:
Hi XXXXXXX
Thanks for asking again.
Reducing PSA level does indicate the reducing possibility of prostate cancer.
The earlier cause could have been due to prostatitis and antibiotic therapy could have improved it and hence, PSA level has probably fallen.
With enlarged prostate, repeated risk of urinary tract infection is always present due to urine being retained after voiding.
Followup with next PSA levels. If it is falling, then it is good.
The risk at present based on Total and free PSA is very low for prostate cancer.
If there is repeated urinary tract infection, getting transurethral resection of prostate surgery would be beneficial. If it becomes complicated, then surgery in critical conditions will be serious.
If the followup PSA levels are rising again, get a needle biopsy. Mild bleeding is possibly the major complication. Otherwise not much.
Hope it helps.
Any further queries, happy to help again.
Dr. Jyothi BL
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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