Prostate-specific antigen, or PSA, is a protein produced by prostate cells. It usually stays within a certain range in healthy men, but cancer can interfere with this process. As a result, PSA levels can rise above the normal level and may be a sign of disease. The test can also be used to monitor a patient after treatment for prostate cancer or other conditions, to detect recurrence. It is a common screening test because it’s noninvasive and relatively cheap.
Several things can cause PSA levels to increase, including a benign prostatic hyperplasia (BPH), an enlarged prostate gland, and other health conditions. BPH can affect the bladder and urinary tract, leading to symptoms such as frequent urination and difficulty urinating at night or during exercise. It is also a common cause of urinary incontinence in older men.
PSA levels can be influenced by a number of factors, including diet and exercise. It’s best not to exercise on the day of a PSA test, as it could raise your levels temporarily and give an inaccurate reading. A diet high in fat and protein can increase PSA levels. Certain medications can also lower PSA, such as the male hormone testosterone and 5-alpha reductase blockers like finasteride and dutasteride. These drugs are prescribed for men with enlarged prostates and can reduce the size of the prostate, which in turn lowers PSA levels.
Stress is another factor that can increase PSA levels. Stress and anxiety can lead to an overproduction of cortisol, a hormone that is linked to inflammation and elevated levels of prostate-specific antigen (PSA). Having regular relaxation and decompression activities can help to lower stress and therefore decrease PSA levels.
A PSA test can miss up to 15% of cancers, so just because your PSA is above the normal range doesn’t mean you have cancer. If your doctor suspects you have prostate cancer, they will typically perform an ultrasound-guided biopsy and a digital rectal exam (DRE).
The DRE is done by inserting a finger into the rectum to feel for lumps or bumps. The doctor will also ask you questions about any pain or urination problems you’ve been having. This information will be compared to your PSA results to help them determine whether you have prostate cancer. If the DRE and PSA results are both positive, your provider will most likely recommend an MRI or a biopsy to confirm if you have prostate cancer. These tests are more accurate and can better identify the type of prostate cancer you have and its progression. They can also help guide treatment, if needed. You should always follow up with your provider after a prostate cancer diagnosis to make sure there are no signs of recurrence.
