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Prostate Cancer

Causes for Elavated PSA

12/18/2007

Question:

I am 50 years old with a history of prostatis and enlarged prostate (last urology appt in 2000 indicated my prostate was large for my age). I had an regular check up with my internist and PSA was 4. So, now gotta go see the Urologist. No history of cancer in family and, in fact, my Dad went through theĀ exact same situation when he was my age (elevated PSA, prostate infections, benign prostate enlargement). So, obviously it is hard not to worry now about prostate cancer but, based on what I have read it would seem I am at low risk and that elevated PSA likely due to other conditions?

Answer:

Elevated PSA is caused by several conditions including enlargement of the prostate, prostatitis, and prostate cancer. Prostatitis can be assessed by obtaining expressed prostate secretions during digital rectal exam. The absence of white blood cells effectively rules out prostatitis. PSA is best utilized by tracking change in PSA over time and therefore, serial PSAs should be obtained to determine the rate of increase. One cannot rule out prostate cancer based upon history alone and I would recommend that you make contact with a urologist who can assess your specific situation and direct your care.

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Response by:

James F Donovan, Jr, MD James F Donovan, Jr, MD
Professor of Surgery
Director of UC Urology
College of Medicine
University of Cincinnati