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A High PSA Level Can Indicate Less Serious Conditions Than Prostate Cancer

The first sign of prostate cancer can certainly be a high PSA level, but it can also be a sign of a less-serious condition.

Here are some reasons you may have an abnormal PSA reading:

1. PSA Levels Are Affected By Age

Your PSA level can increase gradually as you age even without any prostate problems. At age 40, a PSA of 2.5 is the normal limit but by age 70, a PSA of 6.5 could be considered normal.

2. Many Men Under 50 Suffer From Prostatitis

Prostatitis is the most common prostate problem for men younger than 50. Common causes of inflammation in the prostate gland, called prostatitis, can cause high PSA levels.

3. PSA Can Be Elevated Due To Medical Procedures

Anything that traumatically interferes with the architecture around the prostate gland can make PSA go up such as placing a catheter into the bladder. A bladder exam that involves passing a scope or taking a biopsy can also affect PSA levels.

4. BPH May Be the Cause of High PSA In Men Over 50

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate gland. BPH means more cells, so that means more cells making PSA. BPH is the most common prostate problem in men over age 50. It may not need to be treated unless it’s causing frequent or difficult urination.

5. Urinary Tract Infections Can Create High PSA Levels

Any infection near the prostate gland such as a urinary tract infection, can irritate and inflame prostate cells and cause PSA to rise. If you’ve been diagnosed with a urinary tract infection, be sure to wait until after the infection has cleared up before you get a PSA test.

6. Ejaculation Can Be a Potential Cause of Mildly Elevated PSA

Ejaculation can cause a mild elevation of your PSA level. This type of PSA elevation is usually not enough to make a significant difference unless your PSA is borderline.

Arnold Palmer And Other Famous People Diagnosed With Prostate Cancer

The American Cancer Society estimates that 161,360 new cases of prostate cancer will be detected in 2017. Many famous men including actors, politicians and sports figures have been diagnosed with prostate cancer, and their diagnoses can help to build awareness for the disease.

The following is a list of only some of the celebrities who have coped with prostate cancer:

• Arnold Palmer: Golfer (see below for Arnold Palmer’s story)
• Harry Belafonte: Singer and actor
• Bob Dole: Former Republican senator from Kansas
• Robert De Niro: Actor and director
• Rudy Giuliani: Former New York City mayor
• Charlton Heston: Actor
• John Kerry: United States Secretary of State since 2013
• Nelson Mandela: Former president of South Africa and anti-apartheid activist
• Francois Mitterand: Former president of France
• Roger Moore: Actor
• Colin Powell: Retired Secretary of State
• Frank Zappa: Musician

Arnold Palmer’s Prostate Cancer Story

Following his own diagnosis, Arnold Palmer became a champion for prostate cancer. His cancer was originally detected based on a rising PSA test, and confirmed with a prostate biopsy. He chose a radical prostatectomy for treatment and remained cancer free until the end of his life in September 2016.

Known for being a world-renowned professional golfer, Arnold Palmer had won dozens of PGA Tour events. He also is recognized for his involvement in politics, such as his personal relationship with President Dwight D. Eisenhower, and his charity work and community outreach, including working with foundations such as the Eisenhower Medical Center Foundation and the March of Dimes.

Arnold Palmer became known as a champion off the greens as well, for his work raising awareness about prostate cancer.

Palmer’s Prostate Cancer Diagnosis

In 1997 Palmer was diagnosed with prostate cancer. He had been getting routine physicals that included a PSA test. Because his PSA result rose steadily with each passing year, his physician ultimately recommended performing biopsies. Initially, these tests showed no evidence of cancer, though the PSA continued to rise in subsequent exams. However in 1997 one biopsy in came back showing the early stages of cancer. The biopsy was confirmed at the Mayo Clinic and he received a diagnosis of prostate cancer.

Palmer chose to undergo a radical prostatectomy to remove his prostate entirely. This was followed by radiation therapy treatments that lasted for seven weeks.

Within two months post-treatment, Palmer was back on the golf course and getting back in tour shape. Palmer did say that he noticed that post-surgery and radiation that he was weaker than he had previously been and that he required a longer time to recover after his practices.

Spokesman for Prostate Cancer Awareness

After his treatment in 1997, Arnold Palmer was at the forefront of prostate cancer awareness and was very public and vocal about his support of PSA testing.

Palmer strongly recommended that men not wait until their 50s to get screened for prostate cancer, and often reiterated that choosing to get this simple blood test can help save a life. He was a true example of someone for whom early detection of the disease proved life-saving.

As part of his prostate cancer advocacy, Palmer founded the Arnold Palmer Prostate Center at the Eisenhower Lucy Curci Cancer Center within the Eisenhower Medical Center near Palm Springs, Calif. This is a non-profit center that offers state-of-the-art prostate cancer treatment options.

In 2002 his dream of opening a cancer research facility in his hometown of Latrobe, Pennsylvania was realized when the University of Pittsburgh Medical Center and Latrobe Area Hospital unveiled the Arnold Palmer Pavilion. This cancer treatment center, a 30,000 square-foot addition to Latrobe Hospital features outpatient oncology and diagnostic testing.

Though Arnold Palmer died on September 25, 2016 of complications from heart problems, his name continues to be linked to prostate cancer awareness.

A High PSA Level Can Indicate Other Things Besides Prostate Cancer

An abnormally high PSA level can be a sign of prostate cancer, but it can also be a sign of a less-serious condition.

There Are Many Reasons For An Abnormal PSA Reading.

When a man has a PSA test it measures a protein in his blood called prostate specific antigen. Prostate cancer makes PSA levels go higher, but a high PSA test result doesn’t always mean a man has prostate cancer.

Sometimes PSA readings are elevated because of something benign and that has nothing to do with cancer. For instance, two reasons could be: ejaculating within 24 hours of the test, or a problem that needs treatment like a urinary tract infection.

Because the test can’t distinguish between serious causes of elevated PSA and other causes, the United States Preventive Services Task Force (USPSTF) has historically recommended against prostate specific antigen (PSA) testing in healthy men/men who have no family history, known risk factors, or symptoms of prostate cancer.

However in 2017, the USPSTF released new draft guidelines that encourage doctors to discuss the potential benefits and harms of using the PSA test to screen for cancer in men ages 55 to 69. The final recommendation statement is now being developed.

Here are five reasons, besides prostate cancer, your PSA level could be above normal.

1. Aging Affects PSA Levels

PSA levels can rise gradually as you age even without any prostate problems. At age 40 the normal limit for PSA is 2.5, and by age 60 the limit rises to 4.5 and even higher at age 70 where 6.5 could be considered normal.

2. A Common Problem in Men Under 50; Prostatitis

Common causes of inflammation in the prostate gland, called prostatitis, can cause high PSA levels, and prostatitis is the most common problem for men under the age of 50, so it is very prevalent. Prostatitis is caused by bacteria and can be treated with antibiotics. However, another type of prostatitis, called nonbacterial prostatitis, can be harder to treat and may last a long time.

3. PSA Can Rise Due to Medical Procedures

A catheter in the bladder or any type of procedure that traumatically interferes with the architecture around the prostate gland can make PSA go up. Another factor that could make the PSA rise is a prostate or bladder exam that involves passing a scope or taking a biopsy.

4. BPH May Be the Cause of High PSA In Men Over 50

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate gland, but it’s not prostate cancer and it is the most common prostate problem in men over age 50.

In some cases a primary care doctor may be able to tell the difference between BPH and prostate cancer by doing a digital rectal exam, but usually this will require evaluation by a urologist and further testing, such as a biopsy or imaging studies.

5. Urinary Tract Infections Can Cause High PSA Levels

A man suffering from any infection near the prostate gland, including a urinary tract infection, can have a higher PSA because the infection can irritate and inflame prostate cells.

Men who have been diagnosed with a urinary tract infection should wait until after the infection has cleared up before they get a PSA test. Having BPH increases your risk for a urinary tract infection.

Despite Not Being Perfect, PSA is Still a Really Important Screening Test for Prostate Cancer.

According to the American Cancer Society, prostate cancer is the third leading cause of cancer death in American men, behind lung and colon cancer.

Four Questions to Ask Your Doctor About Prostate Cancer Surgery

Despite the fact that some media reports have recently been published claiming that prostate cancer has been over-treated, there are many men each year who still need aggressive therapy. Different treatment options each have their own pros and cons.

Men who are considering undergoing a radical prostatectomy will appreciate getting answers to the following questions in order to make an informed decision.

Ask Your Doctor

1. How many of these operations have you performed in the last year?

Research has shown that doctors performing more than 20 prostatectomies per year have a lower complication rate on average than doctors doing less than that number. Some urologists like Dr. Robert Gaertner and Dr. Christopher Knoedler specialize in prostate cancer surgery. Studies have shown that the best results come from very experienced surgeons.

2. What is the likelihood surgery will cure the cancer?

Statistically the best candidates for surgery are patients where the cancer is completely inside the prostate; but even then it is sometimes possible that the cancer will recur. When the cancer is growing outside the gland some men will need radiation after surgery. Ask your doctor to provide you with the odds that the surgery will be enough or whether additional therapy will be needed. The answers to these questions might influence your decision to choose radiation instead.

3. What are the odds of developing side effects?

All types of treatments can have side effects, and they can happen regardless of the expertise of the surgeon. The odds of side effects occurring vary, in part due to the cancer and a patient’s health. It is not enough to know what complications can occur; to make an informed decision, men also should find out the odds of them occurring. Ask your doctor things like: how often do men of my age and health develop impotence, incontinence or a urethral stricture? Ask the doctor how those results were measured. The most reliable information comes from written surveys completed by patients treated by their doctor.

4. Ask what happens if you develop impotence or incontinence; ask how is it treated and what are the odds of success?

Good treatments are available for incontinence or impotence, but some men still find these problems unacceptable. Knowing what can be done may influence your decision for or against surgery. Remember, all treatments can cause complications, but the odds of them occurring vary.

Welcome To Movember; What It’s All About

Welcome to November, the month where all your male friends and co-workers show up clean-shaven and baby-faced on Nov. 1 and look like western-movie villains or grizzly bears by Thanksgiving.

November is a big month for cancer awareness. “Movember” not only raises awareness for cancer it’s also a chance for men to show off their mustaches, goatees, mutton chops and other types of fuzzy face-warmers.

Here’s are some FAQs about the mustachioed month-long event:

Where did Movember originate?

Movember began in Australia in 2003 to raise awareness for prostate and testicular cancers, according to the Movember Foundation. This foundation is a nonprofit that raised more than $21 million in 2016

What is the goal of growing facial hair for a month?

According to Movember’s U.S. Director Mark Hedstrom, “We are all about the mustache and only the mustache. What we’re asking men to do is participate by changing their appearance. What that fosters is a conversation.” Hedstrom said men can explain why they’re growing a mustache and start talking about men’s health.

Where is Movember celebrated?

According to the Movember organization, this month-long event has campaigns in 21 countries.

How can people participate?

To participate in Movember, start with a fresh face at the beginning of the month and “donate your face” until Nov. 30 by not shaving. You’re like a fuzzy billboard for mean’s health issues. You can get your friends and family to donate to the cause.

What if you can’t grow a mo’?

No problem. Not every man can grow a mustache, and that’s OK.

Women can participate in Movember by pushing the men in their lives to grow their mustaches and getting them to be active as part of Movember’s new “Move” initiative.

How common is prostate cancer?

Prostate cancer is one of the most common types of cancers in the United States with an estimated 161,000 new cases in 2017, according to the National Cancer Institute.

How common is testicular cancer?

The NIH estimates that 8,850 people will be diagnosed with testicular cancer in 2017.

African-American Men are at a higher risk of developing prostate cancer

For African-American men prostate cancer is the fourth most common cause of death.

As they age, all men should be concerned about prostate cancer, and it is recommended that they talk with their doctor about if and when they should be screen based on risk factors and their family history. When men who have one or more risk factors, and are at an increased risk of developing prostate cancer, early screening is especially important.

19 percent of black men; nearly one in five, will be diagnosed with prostate cancer. It is estimated that five percent of those will die from this disease.

How Much Greater Is the Prostate Cancer Risk for African-American Men?

There is no way to determine the exact reasons why black men are at an increased risk of developing and dying from prostate cancer. Some experts think it could be caused by delayed diagnosis and limited access to treatment. Researchers are currently attempting better understand the causes, but one recent study done suggests that there may be a genetic link.

African-American men have a dramatically increased risk for the disease if they have a family history of prostate cancer. These men who had an immediate family member who experienced prostate cancer have a one in three chance of developing the disease. When two immediate family members have the disease the risk rises to 83 percent. This number skyrockets to 97 percent if the man has three immediate family members who developed prostate cancer.

It’s So Important To Have Early Prostate Cancer Screening.

Early prostate cancer screening is very important because by the time that symptoms appear, the cancer is likely in an advanced stage. The earlier the prostate cancer is caught — before symptoms appear — the better the chances for recovery.

When caught early, prostate cancer is highly treatable. When prostate cancer is diagnosed in its earliest stage nearly 100 percent of men will be alive five years later.

Age Recommendations are Earlier for Prostate Cancer Screening for African-American Men.

Regular screening is important for all men at the age when prostate cancer becomes more likely. Experts recommend that black men start routine prostate cancer screening at a relatively young age. The American Cancer Society recommends that African-American men discuss testing with their doctor at age 45, or at age 40 if they have several close relatives who have had prostate cancer before age 65.

The family doctor can perform the screening tests. These can include a prostate-specific antigen (PSA) blood test and/or a digital rectal exam (DRE). A digital rectal exam is a quick and only mildly uncomfortable exam of your prostate; the doctor will gently feel the surface of the prostate gland for lumps or other abnormalities.

It is very important for African-American men to be aware of the signs and symptoms of prostate cancer. These symptoms can include:

-Urinating in the middle of the night
-The need to urinate more frequently
-A feeling that the bladder doesn’t completely empty
-Blood in the urine

Gleason Score; What Does it Mean When it Comes to Prostate Cancer?

The Gleason score plays a major role in helping patients who have been diagnosed with prostate cancer determine their outlook and treatment plan.

After a doctor diagnoses prostate cancer, a biopsy of the cancer cells in the prostate will be done. The Gleason score is then used by the doctor to help explain the results, determine how aggressive the cancer is and to plan the best course of treatment.

What is a Gleason score?

The Gleason score is a grading system devised in the 1960s by a pathologist called Donald Gleason and it measures the progress of a cancer call from normal to tumorous.

Five decades ago Mr. Gleason discovered that cancerous cells fall into five different patterns; these patterns change from normal cells to tumorous cells. He determined that these patterns they could be scored on a scale of 1 to 5.

Low Gleason scores

Cells that score a 1 or 2 look similar to normal cells and are considered to be low-grade tumor cells.

High Gleason scores

Cells that score closest to 5 are considered high-grade. These have mutated so much that, in comparison to the low grade cells, they have mutated so much that they no longer look like normal cells.

How is the Gleason score worked out?

The results of a biopsy are used to determine the Gleason score. During a biopsy, the doctor takes tissue samples from different areas of the prostate. Because cancer is not always present in all parts of the prostate, several samples are taken.

Using a microscope to examine the samples, the doctor finds the two areas that have the most cancer cells and assigns the Gleason score to each of these separate areas. Each sample area is given a score of between 1 and 5. The scores are added together to give a combined score, often referred to as the Gleason sum. In most cases, the Gleason score is based on the two areas described above that make up most of the cancerous tissue. However, there are some exceptions to the way scores are worked out.

When a biopsy sample has either a great deal of high-grade cancer cells or shows three different types of grades, the Gleason score is then modified to reflect the prediction of how aggressive the cancer will be.

What do the results mean?

When a doctor tells a patient their Gleason score, it will be between 2 and 10. Although it is not always the case, generally the higher the score, the more aggressive the cancer tends to be. Typically, lower scores indicate less aggressive cancers.

In most cases, scores range between 6 and 10. When biopsy samples score 1 or 2 they are generally not used because they are not usually the predominant areas of cancer.

A Gleason score of 6 is usually the lowest score possible. Prostate cancer with a score of 6 is generally described as well-differentiated or low-grade. This indicates that the cancer is more likely to grow and spread slowly.

Scores between 8 and 10 are referred to as poorly differentiated or high-grade, and in these cases, the cancer is predicted to spread and grow quickly.

In some cases, a patient may receive multiple Gleason scores because the grade may vary between samples within the same tumor or between two or more tumors. In these instances, the doctor is likely to use the highest score as the guide for treatment.

UroNav Fusion Biopsy System Improves Prostate Cancer Detection and Treatment

A high-tech MRI-ultrasound imaging system can result in fewer biopsies and better treatment decisions for prostate cancer patients. Dr. Robert Gaertner and Dr. Christopher Knoedler are experts in the UroNav® fusion biopsy system and have this technology available for their patients.

UroNav is a unique technology that fuses images from magnetic resonance imaging (MRI) with ultrasound to create a detailed, 3-D view of the prostate. When physicians use this improved view, it helps them perform biopsies with much higher precision, and increases prostate cancer detection.

Many prostate cancer specialists feel that UroNav revolutionizes how they diagnose prostate cancer and make treatment decisions. Before UroNav was available, when prostate cancer was suspected due to results of a PSA blood test or digital rectal exam, a physician performed a prostate biopsy which typically involved sticking a needle into 12 different areas of the prostate. This traditional method can miss a tumor. Because of this fact, physicians were led to falsely conclude that either the patient didn’t have cancer, or they were forced to perform one or more additional biopsies to find the suspected tumor.

When this new fusion biopsy system is used, the patient undergoes a MRI exam before undergoing a biopsy. The MRI is used to detect and pinpoint lesions in the prostate that may be cancerous. The MR image is fused with ultrasound imaging in real time during the actual biopsy. The system employs GPS-type technology to let the doctor guide the biopsy needle directly to the exact lesions detected by the MRI, leading to significantly fewer needle biopsies.

This technology when compared with traditional biopsy techniques that randomly sample the prostate, is a vast improvement. It is instrumental in helping physicians detect hard-to-find and often aggressive prostate cancers and can help provide greater certainty regarding the extent and aggressiveness of the disease. In many cases it makes it possible for patients to avoid multiple and unnecessary repeat prostate biopsies.

Biopsies guided by MRI/ultrasound fusion will also enable physicians and patients to opt for active surveillance, instead of surgery when appropriate. When patients are put under active surveillance, they hold off on having surgery or radiation and instead undergo periodic digital rectal exams, PSA tests and ultrasounds to see whether the cancer is growing.

Surgery Seen as Superior to Radiation Therapy in Younger Men with High-risk Prostate Cancer, Study Finds

A recent study concluded that men under age 60 with high-risk prostate cancer who underwent radical prostatectomy; or surgery to remove all or part of the prostate; as an initial treatment, showed significantly improved overall survival at four years than those given radiation therapy.

Researchers used the National Cancer Database to analyze 16,944 high-risk prostate cancer patients, age 59 or younger, who had Gleason scores of 8 to 10 with no metastasis or nodal involvement. The study included data collected between 2004 and 2013.

Of the study population, 12,155 men had radical prostatectomy, and 4,789 had external beam radiation therapy (EBRT) — alone or in combination with brachytherapy — as a first therapy. In 82.5 percent of radiation-treated patients, hormone therapy was also used. Post-operative radiation therapy was given 17.2% of those who had a radical prostatectomy.

After a median 50-month follow-up, statistical modeling was used to determine differences in overall survival between the two groups, and found a significant 48 percent improvement in those who underwent surgery. The estimated survival rate at eight years was also higher in this group, 85.1 percent versus 74.9 percent, respectively.

“When a younger man has high-risk prostate cancer, it generally makes sense to choose surgery over radiation,” a prostate cancer surgeon and urologic oncologist said in a recent press release. “Radical prostatectomy has many advantages over radiation which include shorter recovery times, less pain, and from what this study is showing, the prostate cancer is removed with a higher cancer control and survival rate.”

The findings were presented at the 2017 American Society of Clinical Oncology Annual Meeting, which took place in Chicago in early June. The study was published in the Journal of Clinical Oncology, under the title “Survival impact of initial local therapy selection for men under 60 with high risk prostate cancer.”

It concluded: “Compared to RT [radiation therapy], initial treatment of men under 60 with high risk PCa [high-risk prostate cancer] with RP [radical prostatectomy] results in a large, statistically significant improvement in overall survival that remains consistent over time and remains significant in a multivariable model adjusting for known prognostic variables.”

Shortcomings noted by the study’s researchers included its retrospective nature as a database analysis, and a lack of cancer-specific survival information.

Social Media Is Helping To Support People Diagnosed With Cancer

The digital age has changed the way we live, the way we work and now it has also changed the way we view cancer. In addition to offering a world of information, the internet can offer hope, solace and support to cancer patients.

On Twitter, clicking a hashtag like #prostatecancer can instantly return thousands of people who are going through prostate cancer. It can also lead patients to helpful information about the latest treatments or clinical trials.

There are also Facebook groups that offer a safe haven for patients to share some of the thoughts and fears that they might not feel comfortable sharing with their family, friends, or even doctors.

Support groups whether in-person or online can also serve as passive places to read and digest other people’s experiences with cancer. Many patients benefit in the feeling that they are “not alone”.

A columnist for the Lymphoma News Today shared a story online about how the fellow lymphoma sufferers she met online have become her closest friends; so much so that they served as bridesmaids in her wedding. She told about how the strength she drew from online support helped her through the darkest times. She said that in her experience, social media became her safe haven.

In addition, blogs, YouTube channels, and Instagram accounts allow users to reach out to others with cancer in faraway places. Many patients report that they have made lasting friendships that endure way beyond their final rounds of chemotherapy or final cancer treatments. Social media has made a huge impact; becoming the 24-hour support group patients need. Patients are comforted when they can reach out and touch and be touched by people who truly understand what life with cancer is like.

Social media also empowers cancer sufferers to share their knowledge and empower themselves and others. Sharing knowledge through online outlets helps patients make informed decisions and be more proactive about their treatments. Today’s patients often bring up new treatment ideas with their doctor; vs. the not so distant past where they were more likely to wait for their doctor’s suggestions.