Cancer or infection - spiking PSA
Hi – I’m 57 and In mid-February I began seeing symptoms of tea colored urine, increased frequency, weak stream which got worse over the next couple of weeks to include fever and an episode of night sweats and finally so much painful urination that I went to the urologist at the beginning of March. He found pus in urine and urine culture bacteria although at a low level – 1,000-9,999- and started me on amoxicillin for what I assumed was either prostatitis or a UTI. He did not take a PSA but my previous PSA test in August, 2022 was 1.2 and has been consistently at that level for 7 years. My symptoms resolved rather quickly and I no longer saw blood in urine so I thought that was the end of it. Fast forward to last week when I decided to get a PSA test at my local lab just to make sure all was well and the result was 18.2!
My primary doc (can’t see urologist until next week) said the more likely cause of such a rapid PSA increase was the infection rather than cancer but I’m still freaking out. My symptoms have resolved and I’m assuming prostate cancer symptoms don’t come and go but the high PSA level is concerning especially since I feel like I’ve cleared the infection based upon lack of symptoms.
Obviously I’m following up with my urologist ASAP but was curious if anyone had a similar experience of such a rapid and dramatic PSA increase – from 1.2 to 18.2 in 8 months. Can a prostate infection cause this? Did I test for PSA too soon without letting the infection clear? How long Bose a prostate infection take to clear? Any thoughts appreciated. Thanks- Tom
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I thinking "freaking out" might be a little premature in this case. Spikes in PSA are often caused by inflammation and or infections. Sounds like you likely had both.
When I discovered my cancer the symptoms were more like mild long term BPH (Benign prostatic hyperplasia) as opposed to an infection of any kind.
Also, as I've watched this forums for a couple years now, a rise like "1.2 to 18.2 in 8 months" is something I don't think I've seen in conjunction with anyone here describing how their PSA rose as a result of PCa during that short of a time period. Mine went from @2 to @11 in three YEARS.
Also, my docs told me that PSA has a 3 day half life, so for your PSA to go from 18.2 back to normal say 1.5 would be in the neighborhood of two weeks at least. I would expect noticeable symptoms to resolve before the organ was fully normal by a least some time period so you'd be right at a bad time for a PSA test. I'd get another in say three months and see what that says.
My guess is a urologist would look at the history, do a digital rectal exam, if that's normal, they'll likely just say get a blood test and see what the PSA is doing. If it's considerably less but still high? Don't be surprised if they say repeat in three months. The current direction that number is moving is the more important piece of information.
Does all this information mean you don't have an issue, no. Nobody can say that at this point, but, it would be one heckofa coincidence. Optimism backed up by careful surveillance is what I think is called for.
Best of Luck to you and I hope it's just a passing thing!
Wow, what a great and helpful comment! I’ve got an appointment with urologist Thursday and assume I’ll get a DRE and another PSA test and go from there. I may push for a MRI even if the DRE is normal though. Thanks so much for taking the time to draft such a thoughtful and informative post.
Thanks for the help. My plan is to get a DRE and retest the PSA this week. My health anxiety makes me catastrophize and the high PSA sent me to Google which sent me to a dark place. Hoping for the best.
Wanted to post an update to possibly help others in a similar situation. – had another PSA test and results were 12.54 so about a 33% decrease in 7 days so doc thinks prostatitis and prescribed another round of antibiotics and monitor my PSA levels. Also a normal DRE. Interestingly, he said a UTI doesn’t increase PSA but prostatitis does but Dr. Google said otherwise. Thanks everyone for their responses.
Mayo says infection can spike
The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, also can increase PSA levels. Therefore, determining what a high PSA score means can be complicated.