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PSA test and prostate cancer: not a definitive indicator

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Every year, approximately 3,000 men in the Netherlands succumb to metastatic prostate cancer. As with all cancer cases, early detection is of paramount importance. Is an elevated PSA level a definitive indication of having prostate cancer? It appears to be a bit more nuanced.

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PSA, prostate-specific antigen, is a protein produced in the prostate gland and is exclusive to males. What can cause a false high PSA reading? There can be various reasons for an elevated PSA level, and we’ve outlined some for you.

Causes of Elevated PSA Levels

 Age: It’s normal for PSA levels to increase as you age, as the prostate may enlarge in some men.

Benign Prostatic Hyperplasia (BPH): A common cause of elevated PSA is benign prostatic hyperplasia, also known as BPH. While BPH is unrelated to cancer, an enlarged prostate can raise PSA levels.

Prostatitis (Prostate Inflammation): Inflammation of the prostate can lead to an increase in PSA levels. Prostatitis can be acute or chronic and often causes pain and discomfort in the genital area.

Prostate Cancer: One of the most serious reasons for elevated PSA is prostate cancer. While an increased PSA level does not always indicate cancer, it may be an indication for further investigation, such as a biopsy, to either rule out or confirm prostate cancer.


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Ejaculation: PSA levels can also rise shortly after ejaculation, but this effect is typically temporary.

Intense Cycling: Prolonged sitting on a bicycle seat “massages” the prostate. The pressure irritates the tissue, leading to a temporary increase in PSA levels in the blood.

Understanding the various factors affecting PSA levels is crucial for accurate interpretation and appropriate medical decisions. Regular check-ups and consultations with healthcare professionals are essential for maintaining prostate health and addressing potential concerns.

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Drawbacks of PSA Testing

Due to various potential causes, an elevated PSA level is not specific to prostate cancer. Measuring PSA in healthy men to identify prostate cancer can result in false-positive cases, leading to unnecessary anxiety and stress.

Another risk is that of overdiagnosis and overtreatment. Routinely determining PSA levels in healthy men may lead to the overdiagnosis of prostate cancer. It’s common for men to have small, slow-growing tumors in their prostate that never cause symptoms or affect health. If these tumors are detected through PSA tests, it can result in overtreatment with potentially unnecessary procedures, such as surgeries or radiation. Moreover, patients may be unnecessarily exposed to the possible complications associated with these interventions, including side effects such as urinary incontinence, rectal bleeding after radiation, or erectile dysfunction

Understanding the limitations and potential risks of PSA testing is crucial for making informed decisions about prostate health and avoiding unnecessary interventions. Regular discussions with healthcare professionals can help individuals navigate the complexities of prostate cancer screening and choose the most appropriate course of action based on their individual health circumstances.


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Considering a PSA Test? Consult Your Doctor First

For these reasons, the PSA level is typically assessed only when there is a specific reason, such as in men with prostate issues or those at an elevated risk of prostate cancer due to factors like age, family history, or other risk factors.

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Are you contemplating getting a PSA test? Prioritize a discussion with your doctor to ensure you are well-informed about the necessity, the pros and cons, and that the test results are appropriately contextualized. Consulting with your healthcare provider will help you make informed decisions tailored to your individual health circumstances.

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