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Sex and PSA Level

Hunt2871
Posts: 10
Joined: Mar 2018

My first Urologist, and the one who initially diagnosed my cancer, warned me against having sex (orgasm) for 72 hours prior to having blood drawn.  I had a PSA  test 2 weeks ago and it went up nearly a full point from somewhere in the mid 6's to the mid 7's (I do not have the numbers in front of me) in 12 weeks.  I forgot about his having told me this (my current urologist nor anyone at MD Anderson has given me this warning that I remember) and my wife and I had sex about 30 hours or so before I had blood work done.  Is it true that sex can increase PSA levels and if so to what extent? 

 

The first PSA test that I had when I was initially diagnosed was either in the 14's or 19's...nearly scared me to death as my father, who had PC at 63, said his never got above 10.  This test was done again the next day at a different lab and it was 4.7.  My urologist told me that the labs were constantly doing this!!!!

 

My PSA is increasing no doubt but the last jump was the most significant (nearly a full point in 12 weeks) and has me seriously thinking about getting treatment......but if sex can increase PSA maybe Im worried about nothing?

Clevelandguy
Posts: 440
Joined: Jun 2015

Hi,

You might want to get it re-done on your next checkup, having sex before can make you psa go up.  Remember one point does not make a graph, you need at least three, chill man, chill.❄️☃️  4.7 is a little on the high side(4+is usually the concerning number).

Dave 3+4

Hunt2871
Posts: 10
Joined: Mar 2018

"Hi,

You might want to get it re-done on your next checkup, having sex before can make you psa go up.  Remember one point does not make a graph, you need at least three, chill man, chill.❄️☃️  4.7 is a little on the high side(4+is usually the concerning number)."

You have a very good point.  I am scheduled to have a biopsy in early september and will get another PSA test priod to that. My PSA level is trending upwards over the last 4 years...from 4.7 in May of 2015 to 6.4 in Februrary year and then 7.2 in May.  Not excessive obvious but still somewhat concerning.  I will make certain to abstain from sex at least 72 hours before my next PSA test and I'll post the results so anyone else with this question might have an idea, anecdotally, of what the impact of having sex within 72 hours of a PSA test may mean.

You also have a great point about chilling out!  I have probably had elevated PSA levels for at least 10 - 11 years and, until the Army contacted me and informed me there may have been a problem with the results of the initial test they performed I would probably still be blisfully ignorant of the fact that I do indeeed have the very early stages of prostate cancer and, combined with positive genetic testing and active sureveillance results my cancer has not progressed significantly in the 4 years since I was told my first biopsy did indeed show that I had cancer. 

My whole take on AS is to delay the side effects of any treatment in order to maintan  as high a quality of life as possible for as long as possible with the knowledge that at some point I will reach a point where the side effects of treatment are preferable to the cancer spreading or in some other way worsening.  Depending on the results of my next biopsy and PSA test and possible another MRI I am probably close to that point now from a "comfort" aspect...comfortable with AS. 

I work pretty hard at remembering how fortunate I am to have been diagnosed at a stage where I have so many options, that I have the means to seek any treatment available (I can only imagine having to deal with these issues and money / insurance issues in the mix), I am othewrise healthy, I am in a loving marriage of 27 years and my wife is supportive in every way imaginable......but there are times when I come as close to panic as I have ever done in my life when I dwell on having cancer of any sort too much.  I guess doing otherwise would be strange...either being totally unconcerned or immoblilzed with fear....but it does creep on you from time to time.....

Georges Calvez
Posts: 243
Joined: Sep 2018

Hi there,

I would not get too hung up on your PSA level as it can fluctuate wildly for no good reason.
Some of the reasons are sex, DRE's, bike riding, etc, think of the prostate as being a squashy gland that leaks PSA into the blood and you are about there.
An elevated PSA level has some diagnostic value for detecting prostate cancer although BPH and prostatitis can be other reasons.
A rising PSA level if confirmed by at least three successive assays is a worrying trend.
There is not a one to one reaction between the reagent used to detect it and to make it more fun PSA comes in various forms so there is variation between the different assays and even batches of reagent using the same assay.
If something better came along tomorrow biochemistry labs would abandon the current PSA assay in droves as soon as they could get the doctors to accept the new assay.
Here are the results from a guy that had his PSA taken everyday for 28 days straight by the same lab using the same assay with no changes to his treatment regime, etc.
Look at how they zing around for no reason at all!
https://www.yananow.org/PSAexperiment.shtml

Best wishes,

Georges

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3275
Joined: May 2012

Hunt,

Some studies suggest that sex or other activities can affect PSA, 'some.'  However, the evidence I have seen here has been mostly ancedotal.   My urological surgeon, and the other 15 urologists in his group, as well as my medical oncologist, and my family doctors (2), have all consistently told me that sex before a PSA draw was 'totally irrelevant.'   I have never had sex the night before a blood draw affect my PSA at all.   I am curious as to what your own doctor has to say on this subject ?  It seems he never advised you against sex prior to testing.

Also,  I had chronic, relatively severe, prostatitis for 30 years (yes, years) before my DaVinci, and my Stage 2 disease never caused a PSA reading of over 4.1, ever.  My post-DaVinci pathology report also confirmed the prostatitis, showing extensive (non-cancerous) "inflammed tissue."   And finally, I had BEP (also called BPH) for about a decade prior to surgery, requiring Flowmax.    Aside:  most cases of prostatitis are non-bacterial and non-viral.   As such, the condition will not test positive in cultures, and antibiotics are worthless in such cases (except in the rare cases where the flare is bacterial). 

Dr. Peter Scardino, former Director of Surgery at Sloan-Kettering Cancer Center, NYC, writes in his Prostate Book:  .... 90% of symptomatic....prostatitis and almost all cases of prostatic inflammation in men with no symptoms....are not caused by bacteria (page 59).   His second edition of  The Prostate Book (2010, 565 pages) has a whole chapter on PSA testing, and never mentions sex or any other form of physical activity affecting test results at all.  He does say that swings between tests of up to 30% can occur randomly, with no identifable cause.

By all means, abstain before your next test if you are so inclined. You are thoughful in your study of your treatment options, and I believe INTELLIGENCE is strongly correlated to survivng PCa.  Abstenance certainly cannot skew the results either.  I wish you luck in your current battle, and believe that indeed you will be lucky,

max

Georges Calvez
Posts: 243
Joined: Sep 2018

Hi Max,

You said it there, some men do have swings in PSA levels with no identifiable cause while others show text book stable levels or trends upwards or downwards.
I think patients and doctors put too much weight on PSA levels when they are not a really reliable indicator of the scale or changes in the activity of the underlying cancer.
I have read quite a few articles on the methods of PSA testing and they do not give me a lot of confidence in their test to test reliability. I believe that some swings are due to inaccuracies in the assay method.
It would be interesting to send off a sample taken at the same time to three or five labs using different assay methods, I am sure that each lab would report a different result.

Best wishes,

Georges

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