Dear Dr. Motola,
Can sexual activity just before a PSA blood test make PSA results jump from 2 to 12?
PSA testing immediately after sexual activity remains controversial. The most widely held belief is that patients should wait 3 days after sexual activity prior to obtaining a PSA, however some recent studies suggest that sexual activity will not cause a rise. Repeating the PSA after 3 days of abstinence will be the easiest way to resolve this.
A 62-year-old patient had surgery to remove his cancerous prostate gland about 6 years ago. Two years after surgery his PSA started to rise and now his PSA is 4.6 ng/ml.
I hate to say it but, it is clear that this patient has failed surgery and has "biochemical failure." In other words, his prostate was removed but there is something in his body making his PSA go up and probably more cancerous cells in his body. Even though he feels fine, this rise in PSA is the only sign that his prostate cancer is trying to return. There are two places were cancer can return: 1) in the pelvis where the prostate used to be located, or 2) elsewhere in the body, suggesting that the cancer has spread. Unfortunately, this is a fairly common problem. Up to 30% of men will not be cured by surgery alone and they will have a rise in their PSA months or years after the prostate is removed. That is why it is crucial for men to have their PSA checked on a regular basis after treatment.
There are f...
At What Age Should I Start Getting PSA Tests? The age at which one should first have a prostate cancer screening has been debated. The recommendations of the American Cancer Society are for all patients over the age of 50 to undergo digital rectal examination and PSA testing . However, few weeks go by in the office without a patient under the age of 30 who requests a prostate cancer screening. Using 50 as an arbitrary age cut-off is subject to much discussion. Patients who are at high risk for prostate cancer – such as African-American men or those with a strong family history of a father or brother who were diagnosed with prostate cancer prior to age 65 – should begin screening at age 45. Prostate cancer is the second leading cause of cancer death in African-American males. African-American males have a 60% higher incidence of prostate cancer as well as a higher death rate from prostate cancer than white males – 64% vs. 26.2% according t...
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