“Elevated PSA levels - worried?”
I’m a 53 year old healthy single Caucasian male. I do not drink, smoke, or do drugs, and I’m gay, but sexual intercourse is very limited. I am on the Prep drug Descovy; I’ve had 2 sexual encounters in the last year, both oral sex only. I’m very fit & an avid very active runner & walker, and at the gym with weights several times a week. I am on several medications: Wellbutrin (depression), Crestor (cholesterol), Valtrex (cold sores), and since 2018, on Tamsulosin (Flomax), for very mild incontinence/leakage. For the last 8 years, I consistently get all my annual/semi-annual checkups: dentist, dermatologist (for moles), my quarterly labs for my Descovy, and my annual physical. They were all last week (all the others were fine). My family Dr is detailed & thorough and runs the FULL blood work up, this year expanded to include blood work for all the vitamins. All blood work - including vitamins, CBC, CMP, and lipids, were normal.
There were 2 concerns: 1) all urine levels were normal except they found traces of bacteria. A later culture found no UTI. I will say, I had a recent mild case of jock itch and what I believed to be a mild bacterial infection. There was burning on my testicles but nothing else; an antibiotic from urgent care cleared it up, and good see once then (about a month ago now). I even paid for an extra STD test (for gonorrhea & chlamydia) and was fine. Currently: no other symptoms. No fever, no discharge, no blood (and none found in my urinalysis) no frequent urination or erectile distinction, and feeling fine (I know that doesn’t mean a whole lot but just saying). 2) My overall PSA was elevated to 6.5, in the “gray area.” My other 2 free PSA figures were mostly normal: 1.5 ng/ml, and overall free % at 24. Again, no other physical symptoms & all other blood work were in the normal range. 3) my Dr has called me back in his office tomorrow instead of reviewing by phone. The only thing I could see is the elevated PSA. More testing? Medication? Biopsy? I know my overall free percentage is ok, but with the elevated overall PSA, along with the mild incontinence and recent bacterial infection, he may want to do more tests. I’m a little worried (as I do anyway) and already talked myself into having prostate cancer. I know that may/may not be the case and could be other things, but could be a good enough reason for more tests. I’m sorry this has gone on too long. Thoughts? Ideas?
There were 2 concerns: 1) all urine levels were normal except they found traces of bacteria. A later culture found no UTI. I will say, I had a recent mild case of jock itch and what I believed to be a mild bacterial infection. There was burning on my testicles but nothing else; an antibiotic from urgent care cleared it up, and good see once then (about a month ago now). I even paid for an extra STD test (for gonorrhea & chlamydia) and was fine. Currently: no other symptoms. No fever, no discharge, no blood (and none found in my urinalysis) no frequent urination or erectile distinction, and feeling fine (I know that doesn’t mean a whole lot but just saying). 2) My overall PSA was elevated to 6.5, in the “gray area.” My other 2 free PSA figures were mostly normal: 1.5 ng/ml, and overall free % at 24. Again, no other physical symptoms & all other blood work were in the normal range. 3) my Dr has called me back in his office tomorrow instead of reviewing by phone. The only thing I could see is the elevated PSA. More testing? Medication? Biopsy? I know my overall free percentage is ok, but with the elevated overall PSA, along with the mild incontinence and recent bacterial infection, he may want to do more tests. I’m a little worried (as I do anyway) and already talked myself into having prostate cancer. I know that may/may not be the case and could be other things, but could be a good enough reason for more tests. I’m sorry this has gone on too long. Thoughts? Ideas?
Male | 53 years old
Complaint duration: 7 days
Medications: Wellbutrin, Tamsulosin, Rosuvstatin, Valtrex
Conditions: Depression, mild incontinence
2 Answers
I think, you should see an urologist, usually 50% of men after age 50 start having prostate hypertrophy/hyperplasia and elevated PSA can be related to that.
Thank you ,
Luz A López , md
Ohana Kids & Family Kare
Thank you ,
Luz A López , md
Ohana Kids & Family Kare
Hello!
Sounds like your PSA level was mildly elevated, should be monitored more closely to see a trend. It can become elevated for different reasons such as infections or increased prostate size. If there was a increase in PSA level over a short period of time, seeing a urologist would be best. Sometimes it’s easier discussing these type of test results in person or to possibly repeat s focused exam.
Sounds like your PSA level was mildly elevated, should be monitored more closely to see a trend. It can become elevated for different reasons such as infections or increased prostate size. If there was a increase in PSA level over a short period of time, seeing a urologist would be best. Sometimes it’s easier discussing these type of test results in person or to possibly repeat s focused exam.
