What can cause an elevated PSA?

Key takeaways

  • The PSA test measures the quantity of a protein produced by cells of the prostate gland in a blood sample. It is typically used to screen for and monitor prostate cancer in men.
  • Elevated PSA levels can also be caused by non-cancerous conditions such as age, prostatitis, benign prostatic hyperplasia (BPH), and urinary tract infections.
  • To use an elevated PSA as the basis for ordering a prostate biopsy, it is now recommended that the level of PSA is monitored over time and any changes are monitored regularly, with a suspicious lump detected during a DRE being a more accurate basis for suspecting prostate cancer.

Prostate-specific antigen (PSA) is a protein produced by cells of the prostate gland. It is synthesized by both normal and malignant cells and released in blood. The PSA test measures the quantity of this protein in a blood sample, which is then reported in nanograms of PSA per milliliter (ng/mL) of blood. A PSA level of 4.0 ng/mL and below is often considered normal.

What causes an elevated PSA level?

The blood PSA level is typically elevated in men with prostate cancer. Therefore, the test is usually ordered in conjunction with the digital rectal exam (DRE) to screen men that are asymptomatic for prostate cancer. It is also recommended for monitoring the progression of prostate cancer in men already diagnosed with the disease, and to test men with prostate symptoms to find out the nature of their problem.

Apart from prostate cancer, there are a number of conditions that may increase the PSA level. For instance, PSA is elevated with age, usually due to enlargement of prostate tissue over the years. Prostatitis (inflammation of the prostate), which is a condition common in men under 50 years due to bacterial infection, tends to result in increased PSA level. Other conditions that lead to increased PSA level include benign prostatic hyperplasia (BPH), urinary tract infections, prostate injury, recent ejaculation, high parathyroid hormone, and surgical procedures.

Normal versus abnormal PSA level

Although a PSA level of 4.0 ng/mL or below is often considered normal, the level of the protein can vary over time in the blood of the same man, making what is usually taken as the normal range less accurate. In fact, studies have indicated that some men with PSA level below 4.0 ng/mL have prostate cancer while many men with levels above 4.0 ng/mL have been found free of the cancer.

Besides, due to the various factors that may cause a fluctuation of PSA level, such as age, prostatitis, BPH, and urinary tract infections, having a fixed normal range for all men is unreliable in some cases. Equally, since PSA test results vary from one laboratory to another and because drugs like Dutasteride (Avodart) and Finasteride (Proscar) that are used to treat BPH tend to lower PSA level, a single elevated PSA may not be very helpful.

Therefore, to use an elevated PSA as the basis for ordering a prostate biopsy to ascertain whether prostate cancer is present, it is now recommended that the level of PSA is monitored over time. A continuous trend of increasing PSA in blood over a prolonged period of time, together with a suspicious lump detected via the DRE, is a more accurate basis for suspecting prostate cancer and ordering for a prostate biopsy.

Elevated PSA in prostate cancer screening

For men without symptoms of prostate cancer, an elevated PSA level may be followed by a repeat PSA test to confirm the original finding. And if the PSA level is still high, the urologist may recommend that more PSA tests and digital rectal exams be done at regular intervals so that any changes can be monitored over time. If the PSA level continues to rise or if a suspicious lump is found during a digital rectal exam, the doctor may now order for confirmatory tests.

For example, a urine test may be requested to establish if the rising PSA level is due to a urinary tract infection. Likewise, imaging tests like cystoscopy, x-rays or transrectal ultrasound may help to show the size and nature of any lump.

And if the tests show there could be prostate cancer, the urologist will recommend a prostate biopsy.  Multiple samples of prostate tissue are collected by inserting hollow needles into the prostate through the wall of the rectum. The samples are examined by a pathologist to confirm whether the cells are cancerous or not.

Elevated PSA in monitoring prostate cancer treatment

After treatment for prostate cancer, the urologist will want to continue to monitor the PSA level to establish whether the disease is recurring or not. An elevated PSA level after treatment is usually the first sign that the cancer is recurring. In fact, an elevated PSA after treatment often happens many months or years before the signs and symptoms of prostate cancer recurrence show.

A single elevated PSA test isn’t enough to conclude that the cancer has recurred. So the urologist will recommend that the test be repeated a number of times, and be done together with other tests, to check for evidence of prostate cancer recurrence. Repeated PSA tests help the doctor to establish a trend over time instead of relying on a single elevated PSA level.

At Advanced Urology Institute, we are committed to the highest standards of urologic care. We make sure to use the right diagnostic and treatment tests, techniques and procedures to deliver the best possible outcomes for our patients. That is why when it comes to the PSA test, we do not rely on a single elevated result to draw conclusions about your prostate health.

It is our practice to monitor elevated PSA for a prolonged period of time and to use the test alongside risks factors (age and family history) and other tests like the digital rectal exam, before we can make conclusions regarding your prostate health. We believe that an elevated PSA level is a valuable tool for early detection of prostate cancer and for successful treatment of the condition if the test is used properly. For more information on prostate cancer diagnosis and treatment, visit the site “Advanced Urology Institute.”

References

What to Expect When Having Radiation Therapy

Key takeaways

  • Radiotherapy is a treatment for cancer that uses high doses of radiation to kill cancer cells. It may be used before, during, or after surgery, and can also be used in conjunction with chemotherapy.
  • A radiation oncology team typically includes a radiation oncologist, radiation oncology nurse, medical radiation physicist, dosimetrist, and radiation therapy technologist, who work together to design and administer the treatment plan.
  • Before radiotherapy treatment begins, a patient will typically be referred to a radiation oncologist, have their medical records reviewed, undergo a physical exam, and have imaging scans to locate the tumor. The patient will then be asked to sign a consent form and a treatment plan will be developed before the first session.

Scheduling your initial radiotherapy session can create concern and anxiety. And of course many are worried and feel overwhelmed. 

At Advanced Urology Institute, we encourage our patients to be partners in the process and to educate themselves about the procedures. We believe that the more you know about radiotherapy before your treatment, the more confident you’ll be to face the treatment and the more likely you’ll play an active role in your recovery.

So what is radiation therapy?

Radiation therapy is the treatment of cancer using focused high doses of radiation to kill cancer cells. During treatment, specific amounts of the radiation are aimed at tumors or parts of the body affected by the cancer.  Once administered, the radiation kills, stops, or slows down the growth of cancer cells.

Radiotherapy may be used before surgery to shrink a tumor to a smaller size. But it may also be used during surgery to target certain cancer cells. In some cases, radiation therapy is used after surgery to destroy the remaining cancer cells.

When paired with chemotherapy, it can help to improve treatment outcomes. And in cancer cases where a cure is not possible, radiation therapy can be used for palliative purposes—to reduce pain, pressure or other side effects of treatment.

While the radiation affects all cells, healthy ones are able to repair themselves and recover their normal cell function after treatment. Alternatively, unhealthy cells, such as cancer cells, aren’t able to repair after radiation.  Hence, the treatment helps to destroy and eliminate unhealthy cells with minimal adverse effects on healthy cells.

What is a radiation oncology team?

Typically, radiotherapy is designed and administered by a team of highly trained medical professionals. The team usually includes a radiation oncologist, radiation oncology nurse, medical radiation physicist, dosimetrist, and radiation therapy technologist.

The radiation oncologist is the doctor who specializes in delivering radiotherapy for treating cancer and who oversees the overall treatment protocols. The doctor works closely with other team members to develop the treatment plan.

The radiation oncology nurse is skilled and experienced in caring for patients receiving radiation therapy. The nurse answers patient questions about the treatment, monitors the patient’s health during the treatment, and helps to manage the side effects.

The medical radiation physicist designs the treatment plan and is an expert in using radiation equipment. To ensure the right doses are administered with accuracy and precision, the radiation physicist is a key member of the team.

And finally, the radiation therapy technologist (radiation therapist) will directly operate the treatment machines such as a linear accelerator during therapy sessions and give the scheduled treatments. Other professionals might include social workers, nutritionists (dietitians), dentists, and rehabilitation therapists, such as physical therapists or speech therapists.

What happens before your treatment?

You’re usually referred to a radiation oncologist when your doctor believes radiotherapy might be an option worth considering. The radiation oncologist will then review your medical records, conduct a physical exam, and order various tests. The doctor then explains your options, speaks with you about the potential benefits and risks of the treatment and answers questions.

If you decide to proceed with radiotherapy, you’ll be asked to grant permission by signing the consent form. Your treatment team will then design the treatment plan before your first session.

Your treatment team will use imaging scans, such as computed tomography (CT), X-ray, and magnetic resonance imaging (MRI) to identify the tumor location. You’ll then receive small marks on your skin to assist the team in targeting the radiation beam at the tumor.

In addition, you may be fitted with immobilization devices such as tapes, foam sponges, headrests, simply molds or plaster casts. These items will help you stay secure and in the same position throughout treatment. If the radiation is targeting your head or neck, you may receive a thermoplastic mask, which is a mesh mask molded to your face and secured to the table. 

Though it is crucial for your body to remain in the same position for each treatment, your oncology treatment team cares about your comfort and would like to hear your suggestions. So speak up about how you’re feeling. Communicate with the team so you can find a comfortable position every time.

What happens during treatment?

Radiotherapy is generally scheduled for five days a week over a six to seven week period although the treatment can last for as little as two to three weeks if the goal is merely palliative. Over the course of treatment, you’ll receive small doses (fractions) of daily radiation instead of large doses. This helps to best target cancer cells and protect healthy cells in the treatment area. Compliance and consistency is key. It is advisable that you complete all your sessions as scheduled and not miss or delay any treatments. 

Before treatment is administered, your radiation therapy technologist will ask you to change into a gown and lie on the movable bed. The marks on your skin are used to position the machine and table—though you may be positioned using molds, boards or special holders. If necessary, special blocks or shields are used to protect your normal organs. You’ll then have to remain still in that position during your treatments breathing normally.

For each treatment session, you’ll be in the room for 10-30 minutes with the radiation administered for 1-2 minutes of that time. As soon as the treatment begins, the radiation therapy technologist will leave you alone in the room with a closed circuit TV and an intercom. The technologist will see and hear you at all times. So if you think you need to move, just notify the therapist and the machine will be turned off and adjusted.

The technologist controls the machine from outside as treatment progresses and monitors the machine at all times.  The treatment is painless and you’ll not see, smell or hear the radiation. In between your treatment sessions, you’ll need to undergo various tests and checks to confirm that the treatment is going on as earlier planned.

For instance, port films will be taken to ensure the positioning remains as it should be. Weekly blood tests may also be run to check your blood cell counts. Plus, your radiation oncologist will meet with you once a week to assess how your body is responding to treatment. Be sure to tell the doctor of any changes or concerns.

Top-notch radiotherapy services

At Advanced Urology Institute we provide cutting-edge treatments for cancer. Our radiotherapy service is tailored to deliver specifically targeted radiation to precisely target and kill cancer cells.

For more information on radiotherapy and other forms of cancer treatment, visit the site “Advanced Urology Institute”.

References:

What are the Conditions We Treat at Advanced Urology Institute?

Are you looking for comprehensive, effective, and safe urology services in Florida?

Advanced Urology Institute is here for you. 

With a healthcare institure designed to provide excellent, compassionate, patient-centered urologic care, Advanced Urology Institute offers top-notch, life-changing, and life-saving urology services. 

Through our experienced board-certified physicians, we’ve become a one-stop center for evaluation, diagnosis, treatment, and care for all types of urological conditions. 

We have well-equipped, thoroughly-resourced urology centers throughout the state of Florida, ensuring you can enjoy and access the highest level of care from a facility near you.

What conditions do we treat?

At Advanced Urology Institute, we use a multidisciplinary approach to help our patients diagnose, treat manage and recover from all urologic conditions. 

This includes prostate enlargement, urinary incontinence, overactive bladder, urinary tract infections, painful urination, kidney and bladder stones, erectile dysfunction, and cancers of the bladder and kidney, ureter, and testicles.

For the men, we offer diagnosis and treatment of:

  1. Enlarged prostate (BPH)
  2. Bladder problems
  3. Erectile dysfunction and male infertility
  4. Penis and testicle problems
  5. Low testosterone (low T)
  6. Peyronie’s disease
  7. Urinary incontinence
  8. Overactive bladder
  9. Vasectomy and vasectomy reversal
  10. Urinary tract infection
  11. Prostatitis
  12. Kidney stone removal

For the women, we diagnose and treat:

  1. Chronic pelvic pain
  2. Vaginal dryness
  3. Vaginal pain
  4. Pelvic organ prolapse
  5. Urinary tract infections (UTIs)
  6. Urinary incontinence
  7. Overactive bladder
  8. Interstitial cystitis
  9. Pyuria
  10. Kidney and bladder stone removal

Life-saving cancer care

We offer safe and effective state-of-the-art treatments, minimally-invasive surgical procedures, and palliative care for cancer patients who desire the highest level of cancer care. 

Our medical and surgical teams take a collaborative approach to treatment. Integrating expert knowledge from recent research and various innovations and specialties, we can ensure every patient receives the utmost care for the best possible outcomes.

We diagnose and treat:

  1. Prostate cancer
  2. Testicular cancer
  3. Bladder cancer
  4. Kidney cancer
  5. Urethra cancer
  6. Retroperitoneal tumors
  7. Soft tissue tumors

Wide range of revolutionary technology

Advanced Urology Institute boasts a friendly and supportive environment where providers offer urology services that integrate the latest technology in diagnosing and treating various conditions. 

As a result, AUI has an exceptional track record in diagnosing and treating urological problems and a reputation for outstanding outcomes for patients.

Some of the techniques we use include:

  1. Minimally-invasive incontinence procedures
  2. Da Vinci robotic-assisted surgery for prostate, bladder, and kidney cancer, female pelvic prolapse, and pediatric and adult urologic conditions
  3. Minimally-invasive prostate surgery
  4. Reconstructive bladder and kidney surgery
  5. Partial and total nephrectomy
  6. Endoscopic stone surgery, including percutaneous techniques
  7. Minimally-invasive endoscopic, percutaneous, and shockwave nephrolithotomy for renal calculi
  8. Urodynamics
  9. Penile implant surgery
  10. Testosterone replacement therapy
  11. Vasectomy and vasectomy reversal
  12. Sacral nerve stimulator (interstim)
  13. Botox injections
  14. Pediatric surgery, including circumcisions, hypospadias, and orchidopexy
  15. Cryoablation and cryotherapy for prostate cancer
  16. MRI fusion biopsies of the prostate
  17. Radiotherapy including brachytherapy, oncology services, and clinical trials

Safe, reliable, and effective urology care

At Advanced Urology Institute, we are committed to treating others as we would like to be treated. We value and prioritize the wellbeing of our patients and want to see them overcome their condition and live fulfilling lives. 

We offer urology services tailored to our patient’s needs and give safe, effective therapies that will deliver the best outcomes.

When you visit AUI, you will feel at ease and encouraged by the support you will receive.

We are committed to answering all your questions and providing you with the best information to help you make the best decisions about your health.

Call us today to schedule your consultation and find relief from your urological problem.

What Are the Side Effects of Prostate Cancer Treatment?

My name is Rishi Modh, I’m a board certified urologist with Advanced Urology Institute. 

So quality of life after prostate cancer can be a big problem for guys. We do a great job of treating the cancer but sometimes we’re left with side effects. Those side effects often include urinary incontinence for guys or erectile dysfunction. Thankfully now we have great solutions for those problems too. One of the best options we have for guys is penile implants. A penile implant is a device that is an hour long surgery with a small incision done as an outpatient where you go home the same day. This provides lasting great erectile function for men, it really restores your quality of life.