Cancer or infection?
Hi - I’m 57 and In mid-February I began seeing symptoms of tea colored urine, increased frequency, weak stream which got worse over the next couple of weeks to include fever and an episode of night sweats and finally so much painful urination that I went to the urologist at the beginning of March. He found pus in urine and urine culture bacteria although at a low level - 1,000-9,999- and started me on amoxicillin for what I assumed was either prostatitis or a UTI. He did not take a PSA but my previous PSA test in August, 2022 was 1.2 and has been consistently at that level for 7 years. My symptoms resolved rather quickly and I no longer saw blood in urine so I thought that was the end of it. Fast forward to last week when I decided to get a PSA test at my local lab just to make sure all was well and the result was 18.2!
My primary doc (can’t see urologist until next week) said the more likely cause of such a rapid PSA increase was the infection rather than cancer but I’m still freaking out. My symptoms have resolved and I’m assuming prostate cancer symptoms don’t come and go but the high PSA level is concerning.
Obviously I’m following up with my urologist ASAP but was curious if anyone had a similar experience of such a rapid and dramatic PSA increase? Can a prostate infection cause this? Did I test for PSA too soon without letting the infection clear? Any thoughts appreciated. Thanks- Tom
Clevelandguy Member Posts: 825 Member
A UTI can cause a spike in your PSA which hopefully is your case. If it was me I would do another PSA test in a few months to see if your numbers are decreasing or back to normal. Another non cancerous cause of high PSA readings is BPH(Benign Prostate Hyperplasia) or enlargement of the Prostate. Hope for the best….
Thanks Dave. Good advice. I was diagnosed with BPH years ago. My plan is to see the urologist this week for a DRE and PSA retest and likely push for an MRI regardless of the outcome. Hope your recovery is going well. Thanks for taking the time to respond.0
ASAdvocate Member Posts: 189 Member
My PSA has been 4 although I was diagnosed with Gleason 6 prostate cancer in 2009. That minimal cancer never progressed, and is not a major concern of mine or my doctors.
But, about six months ago, my BPH caused a blockage and total urine retention. Had to use a catheter for a month while waiting for Flomax to kick in. I have both PAE and aquablation scheduled in May to fix the BPH.
BUT, a PSA was done when the infection and retention began. It spiked to 116. It went down to 18 a week later, and no doctor wants to test my PSA again until the blockage and inflammation is resolved.
So, yes, you can have a very high PSA caused by infection, not by prostate cancer. But, it will be very painful and obvious.0
Max Former Hodgkins Stage 3 Member Posts: 3,780 Member
Your PSA history is tricky and pretty unusual. I had chronic Prostatitis for 35 years (yes, 35 years), and later, Stage II PCa. Never in my life have I had a PSA above 4.2. Be aware of the odd fact that most prostatitis is non-bacterial and non-viral. That's right: it is not any known form of infection, so antibiotics in most cases are worthless. The pathology of my gland after removal (prostatectomy) showed 'significant inflammation of tissue and resultant scar tissues of no clear etiology.'
Think through the possibilities: To go from a one-digit PSA to a PSA of over 110 in one year would require an astronomically aggressive disease, and that scenario is improbable. The PSA Vector would be off the charts. And, you would very likely have secondary issues, such as a positive DRE. BPH alone would fully account for the need for Flowmax, which I took for well over a decade.
As everyone has suggested, the best course is to have your urologist monitor this closely, including numerous PSA blood draws.
Wanted to post an update to possibly help others in a similar situation. - had another PSA test and results were 12.54 so about a 33% decrease in 7 days so doc thinks prostatitis and prescribed another round of antibiotics and monitor my PSA levels. Also a normal DRE. Interestingly, he said a UTI doesn’t increase PSA but prostatitis does but Dr. Google said otherwise. Thanks everyone for their responses.0
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