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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.
Several statistical terms are important to understand when trying to make sense of who should have their PSA tested or their prostate biopsied . The sensitivity of a test refers to the proportion of individuals in a population that will be correctly identified when tested for a particular disease. The specificity of a test refers to the probability that a person who does not have the particular disease and is tested for the disease will be correctly identified as not having the disease. These statistical analyses provide percentages that relate to identifying false negatives (those with a negative test who actually have the disease), false positives (those with a positive test who do not have the disease), true positives (those who test positive and have the disease) and true negatives (those who test negative and do not have the disease). Any strategy to assess PSA and whether or not testing should occur needs to take into consideration these important concepts...
Dear Dr. Greenstein:
My friend ,who is in his early 50s, just got the results of his annual PSA test - it was between 4-5. The results of his previous 6 annual tests were in the 1-2 range every year, until now. His brother recently had his prostate removed due to cancer.
He now has to see a specialist. We are both very concerned, but should we be that worried?
First, I never tell people to worry before we have all the answers. In this situation, it is crucial to know if this man has any new voiding problems such as burning, slow stream or the sensation he is not emptying his bladder. These symptoms can indicate prostate inflammation, which can falsely elevate the PSA value. In those cases, a course of antibiotics are warranted and the PSA can be repeated after finishing the antibiotics.
If the PSA normalizes then this man can continue to have his prostate examined every 6 - 12 months. The physical exam is also very important. The discovery o...
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