Noncancerous Diagnoses for a High PSA Level

A high PSA level can be an indicator of prostate cancer, but it can also result from less serious conditions. A prostate-specific antigen (PSA) test is a diagnostic tool used to screen for prostate cancer, a disease that affects the prostate gland located between the bladder and the penis in men. According to the Urology Care Foundation, doctors may recommend this test if you exhibit symptoms such as an enlarged prostate, pain in the lower pelvic area, frequent urination, or difficulty while urinating. 

 

In addition to symptoms, your doctor may suggest a PSA test as part of routine care, especially if you're over a certain age or have risk factors for prostate cancer. The test works by measuring the level of PSA, a protein produced by both normal and cancerous prostate cells, in the blood. According to the National Cancer Institute (NCI), higher PSA levels can suggest the presence of prostate cancer, but the test is not foolproof. Some individuals may have elevated PSA levels without cancer, leading to false positives. Keep reading to explore common reasons, beyond prostate cancer, that could cause elevated PSA levels. 

 

Testing for Prostate Cancer 

Prostate cancer is the second leading cause of cancer-related deaths among men in the United States, just behind lung cancer, according to the American Cancer Society (ACS). While many prostate cancers grow slowly and remain confined to the prostate gland, some are more aggressive. Since early-stage prostate cancer often shows no symptoms, PSA screening can help in detecting cancer before it spreads, improving the chances of successful treatment.

However, the PSA test has its limitations. According to the ACS, a higher PSA level does not definitively prove the presence of cancer, and a lower level doesn’t guarantee its absence. False positives can occur when elevated PSA levels stem from other conditions. In some cases, prostate cancer may be so slow-growing that treating it could cause more harm than benefit, leading to a risk of overtreatment. 

 

In light of these complexities, the American Urological Association advises against PSA testing for men under 40 due to the lack of proven benefits. For men aged 40 to 54, routine screening is also discouraged unless individual risk factors are present, such as being over 50, being of African American or Caribbean descent, or having a family history of prostate cancer. Dr. Amin Herati of Johns Hopkins Medicine notes that screening is typically recommended for men between 55 and 69, particularly those at higher risk, and aligns with guidelines from the U.S. Preventive Services Task Force. PSA tests are also useful for monitoring cancer recurrence after treatment. 

 

There is no universal agreement among healthcare providers on the best timing for prostate cancer screening, and recommendations may evolve. It’s essential to have an informed discussion with your doctor about the risks and benefits of PSA testing before proceeding. 

 

Noncancerous Causes of a High PSA Test Result 

 

A high PSA result doesn’t always mean cancer. There are several reasons why PSA levels might be elevated, including: 

 

1. Aging

As men age, their PSA levels naturally tend to rise, even in the absence of any underlying prostate problems. This increase is largely due to the changes in prostate tissue over time. The prostate gland enlarges with age, which can contribute to a gradual rise in PSA production. This is a normal process and does not necessarily indicate cancer. 

 

Doctors use age-based cutoffs to determine what constitutes a “normal” PSA level. For instance, PSA levels above 2.5 nanograms per milliliter (ng/mL) are considered abnormal for men in their 40s and 50s, while levels above 4.0 ng/mL are more concerning in men in their 60s and beyond. These values, however, are not set in stone—what's more important is the rate at which PSA levels increase over time. Even if a PSA reading is within the normal range, a rapid rise from one year to the next could signal an underlying issue, prompting doctors to investigate further. 

 

This gradual increase with age makes it essential for doctors to evaluate PSA results in the context of a patient’s age and personal health history. In many cases, an elevated PSA level in an older man might simply be due to natural aging, but it still warrants careful monitoring over time to rule out other conditions.

2. Prostatitis

Prostatitis is an inflammation of the prostate gland, and it is one of the most common causes of elevated PSA levels, especially in younger men. The Prostate Cancer Foundation reports that up to 50% of men will experience prostatitis at least once in their lifetime, making it a widespread concern. 

 

There are different types of prostatitis, and each can affect PSA levels differently: 

 

 Acute bacterial prostatitis is caused by bacterial infection and often presents with sudden symptoms such as fever, chills, pain in the lower abdomen, and difficulty urinating. Antibiotics are typically effective in treating this form of prostatitis. 

 

Chronic bacterial prostatitis is a longer-lasting bacterial infection that may be more difficult to treat. Symptoms can be milder than in acute cases but are often persistent, leading to long-term discomfort and elevated PSA levels. 

 

Chronic pelvic pain syndrome (CPPS) or nonbacterial prostatitis is the most common form and is not caused by an infection. Its symptoms include chronic pain in the pelvic region, painful urination, and general discomfort in the prostate area. Nonbacterial prostatitis can be more challenging to treat, as the exact cause is often unknown. Factors such as inflammation, nerve damage, muscle spasms, or stress may play a role in its development. 

 

Because prostatitis involves inflammation, it can lead to significant PSA elevation, which may be mistaken for signs of prostate cancer. When prostatitis is suspected, treatment often focuses on reducing inflammation, and PSA levels may return to normal once the condition resolves. However, chronic cases can cause long-term increases in PSA, which can complicate ongoing prostate monitoring. 

 

3. Medical Procedures

Certain medical procedures can also cause a temporary spike in PSA levels. Any trauma or manipulation near the prostate can disrupt the normal balance and lead to an increase in PSA production. Procedures that commonly cause this include:

Catheterization: Inserting a catheter into the bladder, particularly if done forcefully or with difficulty, can traumatize the prostate. This trauma often leads to a temporary rise in PSA levels. Catheters are often used before surgeries or in cases of severe urinary issues. However, the increase in PSA from catheterization tends to subside within a few days. 

 

Cystoscopy: This procedure involves inserting a cystoscope (a thin, flexible tube with a camera) through the urethra and into the bladder to examine the urinary tract. While this test is important for detecting bladder issues such as blockages, narrowing, or cancer, it can also irritate the prostate, leading to a transient increase in PSA levels. 

 

Bladder biopsy: A biopsy of the bladder may be done during a cystoscopy to check for signs of cancer or other abnormalities. This procedure can also lead to elevated PSA levels as a result of the inflammation caused by the biopsy. 

 

While these procedures can cause temporary PSA increases, these elevations are typically short-lived. According to Dr. Herati, a three-day waiting period is usually sufficient to allow PSA levels to return to normal after a minor procedure, such as catheter placement. 

 

4. Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia, or BPH, is an enlargement of the prostate gland that is noncancerous but can lead to elevated PSA levels. BPH is extremely common in older men and is not a form of cancer, but because it involves the proliferation of prostate cells, more PSA is produced, contributing to higher readings. 

 

BPH typically begins to develop in men over 50 and is characterized by an increase in the size of the prostate gland, which can compress the urethra, causing urinary symptoms such as difficulty starting urination, frequent urination, and a weak stream. These symptoms overlap with those of prostate cancer, making it crucial for doctors to distinguish between the two conditions. 

 

To help identify whether BPH or cancer is causing elevated PSA levels, doctors may measure “free PSA,” which refers to PSA that circulates freely in the blood rather than being bound to other proteins. Higher levels of free PSA are more likely associated with BPH, whereas lower levels of free PSA could indicate a higher risk of prostate cancer. This distinction helps doctors decide whether further investigation, such as a biopsy, is needed. 

 

5. Urinary Tract Infection (UTI)

A urinary tract infection (UTI) can also cause a rise in PSA levels. The exact reason is not fully understood, but it is believed that the infection may increase the permeability of the membranes that separate the prostate from the bloodstream. When this happens, more PSA can leak into the blood, resulting in elevated levels. 

 

UTIs are infections that can affect any part of the urinary system, including the bladder, urethra, and kidneys. Common symptoms include a burning sensation during urination, frequent urination, and cloudy or strong-smelling urine. For men with BPH, the risk of developing a UTI is higher, as an enlarged prostate can obstruct the flow of urine and create conditions that encourage bacterial growth.

The Prostate Cancer Foundation advises that men with a UTI should delay PSA testing until the infection has cleared to avoid misleadingly high results. Once the UTI is treated, PSA levels typically return to normal within a few weeks. 

 

6. Ejaculation 

Ejaculation can cause a temporary, mild rise in PSA levels, as can a digital rectal exam. These elevations are usually minor, but doctors often recommend avoiding ejaculation for a few days before a PSA test to avoid skewing the results. 

 

In the end, the decision to undergo PSA testing should be based on a thorough discussion with your doctor. While screening can be beneficial for some men, the risks of false positives, unnecessary treatment, and side effects must also be considered. The ACS recommends talking to your healthcare provider about your personal risk factors and deciding together whether PSA testing is appropriate for you. 

 

For men who choose to undergo the test, your doctor will help interpret the results and guide you through the next steps.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

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When I Told My Doctor I Thought I Had Endometriosis, He Said, 'Stop Practicing Google Medicine'

I always considered myself to be in relatively good health. I had annual checkups, maintained a healthy diet, and tried to exercise. Overall, I was happy to be completely average. True, I had very heavy and lengthy periods, along with bad cramps. But so did my mom. So does my daughter. I thought that’s just how it is.

Then in 2011, after two previously healthy pregnancies, I suffered a miscarriage when I was four months pregnant. Soon after, I started having severe back and leg pain. At first, I blamed it on getting older or the fact that, as a lawyer, I sat so much during the day. When the pain didn’t go away, it seemed likely that it was due to sciatica or a pinched nerve. After a normal pelvic exam and ultrasound, my ob-gyn agreed. So did the chiropractor I consulted.

Mysterious, worsening pain

But despite physical therapy appointments and Pilates classes, the pain never completely cleared up. Not until 2014 did I realize that it worsened during and after my period. I also began suffering from other symptoms like frequent urinary tract infections, constipation, and high blood pressure. Even sex became painful. I felt so confused. If nothing unusual was showing up on my exams and tests, then what was causing my pain?

My ob-gyn suggested that I consult doctors who specialized in uterine issues, but I didn’t do so right away. I couldn't imagine that anything I had could be that bad. Plus, by this point, I’d learned to live with the two weeks on, two weeks off pain. (It required carefully timed Ibuprofen, which dulled the pain so I could function but didn't eliminate it.) It was hard to take time off from my demanding job—not to mention find a good specialist who not only took my insurance but was accepting new patients. I waited 14 months to see a specialist. In hindsight, that was a big mistake.

"Stop practicing Google medicine"

In 2015, while researching my symptoms online, I came across endometriosis, a disorder in which uterine tissue grows outside the uterus. It seemed like a possible cause of my symptoms, yet neither of the two specialists I saw that year mentioned it. When I did, I felt like I was irritating them. In fact, one of the doctors told me to “stop practicing Google medicine.”

Although both said they could treat my symptoms with various medications, they blamed the 20 or so extra pounds I was carrying at the time as the cause. I did try going on birth control pills, which they had suggested. But I had to stop because it made me throw up all the time and gave me bad headaches.

I remember walking out of the second specialist’s office on a hot August day. I had to walk several blocks to the train station, and as I walked, I tried to process my frustration. I decided I’d had it with these so-called “specialists.” No more appointments with doctors who didn’t listen to me. I’d simply deal with my two weeks on, two weeks off pain cycle until menopause.

But the pain kept getting worse. In 2017 my ob-gyn, knowing how exasperated I was, suggested I have another ultrasound. I have a habit of looking at techs’ faces when I get tests. They’re not allowed to say anything, but don’t have the best poker faces. As the tech prodded my left side, I saw her whole face drop. I found out later that she couldn’t find my left ovary.

An abdominal ultrasound was ordered, as well as a CT scan. The results showed that I had a condition called hydronephrosis [kidney swelling, caused by a backup of urine.] It was so severe that my kidney had stopped working. I was astonished. Upset. Scared. And I was at a loss about what to do, since doctors didn’t know the cause.

I went back to Google for answers. This time, I found an obscure blog, where a woman described how her kidney had been impacted by endometriosis. I knew I had to have the condition, too. I began searching for an endometriosis specialist near me.

The right diagnosis—and extensive treatment

Three months later, I met with Tamer Seckin, MD, a New York-based gynecologist laparoscopic surgeon. He'd already taken the time to read all my medical files—and he was horrified that no one spotted what he said were classic endometriosis symptoms, such as back pain and pain during sex.

Besides endometriosis, I had adenomyosis (similar to endo, it's when the uterine lining grows into the muscle of the uterus). Dr. Seckin also diagnosed me with a frozen pelvis, a severe complication of endometriosis that caused my pelvic organs to adhere to my bones. In addition to excision surgery [in which abnormal growths and scar tissue are destroyed], my uterus, both my ovaries, and fallopian tubes would all need to be removed.

The surgery took nine hours; it involved not just Dr. Seckin but also a urologist and colorectal specialist. During the procedure, they discovered that my kidney was infected and swollen to four times its normal size. They had no choice but to take it out as well.

No one feels great after this type of surgery, but truthfully, I was happy. The pain was gone. I vividly remember sitting in the waiting room before the operation, signing paperwork, and being unable to put weight on my left side because of the intense pain shooting down my leg. After the surgery, I was achy and groggy, but the pain on the left side of my body had disappeared.

Recovery was not easy—I was home on disability leave for three months—but the mental peace I finally had was worth it.

Putting dismissive doctors on notice

I agreed to open up about my story because I want other women to not wait for years to get diagnosed. Listen to your body. Believe your symptoms. Do your research and come to your doctors prepared.

We need to put medical professionals on notice that they cannot continue to ignore millions of women who have endometriosis. I want insurance companies to hear this, too, and start covering excision surgeries, which are currently out of pocket and very expensive. I don't want anyone else to lose major organs to endo.

Looking back, I didn’t live—I survived between pain cycles—for seven years. Now, I feel I have a life again.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Superbugs crawling their way out of hospitals

Drug-resistant strains that have a high mortality rate — cases of which were usually seen among people that had recently been to a hospital — are now spreading to people who have had no contact with any healthcare centre for over three months, a recent study has revealed. 

The author of the study said: “The distinction between community-acquired and hospital-acquired infections is becoming increasingly blurred. The main reasons for this are the spread of classically ‘hospital’ strains, particularly resistant Klebseilla and E. Coli, into the community and vice versa, and the repeated admission of individuals to hospitals with long-standing underlying diseases.

Building resistance

“In addition, the contribution of antibiotic resistance to the community through easily available antibiotics often used without medical supervision has resulted in an increasing reservoir of potential infections,” said the Dr. 

He added that resistance to high-end antibiotics by organisms contracted by patients in the community “is a cause for worry and needs further research and proper action plan”.

Infections due to multi-drug resistant organisms have become a serious health concern worldwide.
The study — Association of high mortality with extended-spectrum Beta-lactamase (ESBL) positive cultures in community acquired infections — was conducted to investigate the spectrum of microbial resistance pattern in the community and their effects on mortality.

The study notes that infections due to multi-drug resistant organisms, particularly those producing extended-spectrum Beta-lactamases, are of major concern worldwide.

New generation

ESBLs are organisms that are resistant to various newer-generation antibiotics and can be easily transferred to the community.

These resistant infections pose therapeutic challenges to clinicians in the treatment of these patients and may therefore be associated with high morbidity and mortality.

“The striking point noted in our results is the emergence of E.coli as most common bacteria in the community causing bacteraemia, respiratory and urinary tract infection and higher mortality in ESBL positive producers as compared to ESBL negative producers,” said the Dr. 

Among the 201 patients studied, 63.44% who contracted E. coli were ESBL producers.

Trickling into society

This reflects the increased resistance pattern to high-end antibiotics in Hospital-Acquired Infections due to inadvertent early use of third-generation Beta-lactam antibiotics, such as cephalosporins, which is further trickling over into the community because of “plasmid mediated transfer of its genetic materials during conjugation”, noted the study. 

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HEALTH BENEFITS OF ASPARAGUS

This bright green veggie has been deemed a spring superfood with good reason. It is packed with goodness - vitamins A, C, E, K, B6 and folate, as well as essential minerals like iron, copper, calcium, protein and fiber. In addition, there are many ways this nutritious vegetable can be enjoyed.

1. They may help you lose weight
Asparagus is low in fat and calories (one cup is a mere 32 calories). It is also packed with lots of soluble and insoluble fiber, making it a good choice if you are trying to lose weight, primarily because your body digests fiber slowly, helping you feel satiated in between meals. In addition, asparagus can also relieve constipation and studies have shown that it may help lower cholesterol.


2. They may prevent urinary tract infections
Asparagus contains the amino acid, asparagine, making it a natural diuretic. A diet rich in asparagus could therefore prevent urinary infections from developing as it helps flush excess fluid and salt from the body.


3. They are packed with antioxidants
Purple asparagus is packed with anthocyanins (an antioxidant that gives this type of asparagus its purple hue) which could help your body fight damaging free radicals.

4. They are a great source of vitamin E
This important antioxidant helps strengthen your immune system. Vitamin E also protects the cells from the harmful effects of free radicals.


5. They are a great aphrodisiac
Asparagus is a great source of the vitamins B6 and folate, both of which have been found to help boost feelings of arousal. In addition, vitamin E has also been shown to stimulate sex hormones, including estrogen in women and testosterone in men.

 

6. They can ease a hangover
Research has shown that a side of asparagus may be a better remedy for curing a hangover than a greasy breakfast. A 2009 study published in the Journal of Food Science found that the minerals and amino acids in asparagus extract may help ease a hangover and protect liver cells from the toxins in alcohol.


7. They beat bloating
Asparagus is an anti-bloating superfood. It promotes overall digestive health (due to its soluble and insoluble fiber benefits) and is packed with prebiotics (non-digestible carbohydrates that act as food for probiotics - providing a healthy balance of good bacteria in your digestive tract.) Asparagus can reduce gas, and as a natural diuretic, it can help flush excess liquid reducing a belly bulge.

8. They are a great source of folic acid
Folic acid is essential for women who are trying for a baby, because it can help protect against neural tube defects. According to a study published in 2009, PLoS Medicine found that folic acid can help reduce the effects of premature birth by 50% when taken for at least a year before conception. Just four asparagus spears contain 22% of your recommended daily allowance.


9. They are packed with vitamin K
Asparagus is a good source of vitamin K - a crucial nutrient for coagulation (it helps the body stop bleeding after a cut) and it also contributes to bone health. While calcium is essential for healthy bones, vitamin K can actually help your body absorb calcium.


10. They boost your mood
Folate - a B vitamin found in asparagus - has been shown to lift your spirits and help keep irritability at bay. Studies have shown that low levels of folate and B12 occured among people who suffer from depression. In addition, asparagus contains high levels of tryptophan - an amino acid that has also been linked to better mood.
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New device spots bacterial infection faster

Scientists from the Indian Institute of Technology-Kanpur (IIT-K) have built a new sensor that can detect bacterial infection in food and water in just 15-20 minutes, much faster than traditional laboratory tests.

“Pathogenic bacterial infection is one of the biggest causes of death, and a fast response time is much needed for timely detection and subsequent cure of bacterial infection,” said Saurabh Mani Tripathi, a physicist at IIT-K.

The device, developed with collaborators from the Photonics Research Centre at the University of Quebec in Outaouais works over wide temperature range to quickly and cost-effectively identify the potentially deadly Escherichia coli (E. coli) bacteria.

Found in the environment, food and intestines of people and animals, most strains of E. coli are harmless. But some kinds of E. coli can cause diarrohea, while others cause urinary tract infections, respiratory illness and pneumonia, and other illnesses, according to the US Centres for Disease Control and Prevention.

“Using currently available technologies, which are mostly based on amplification of the sample, it takes several hours to days to detect the presence of bacteria. A fast and accurate detection alternative is, therefore, preferable over the existing technology,” Tripathi noted.

Faster tests for the bacteria could lead to faster treatment of patients, as well as to cheaper and easier environmental monitoring, he said.

The new sensor uses bacteriophages — viruses that can naturally latch onto and kill bacteria.

The viruses are bonded to the surface of an optical fibre and will grab E. coli bacteria from a sample and keep them attached.

When a beam of light strikes the surface, the presence of E. coli shifts the wavelength in a telltale sign of bacterial contamination.
One of the challenges of using optical fibres for bacteria detection is that temperature changes can alter the optical properties of the materials.

Sensors are therefore often designed to work at a particular temperature and give inaccurate readings if the sample gets much hotter or colder.

Tripathi and his colleagues overcame this challenge by adding an additional optical component and in effect canceling out temperature-induced shifts.

Their device, in the journal Optics Letters, is temperature insensitive over an approximately 20-degree Celsius, starting at room temperature and going up to 40-degrees Celsius.

The temperature insensitivity makes the sensor more practical for outdoor applications, like on-site monitoring of water reservoirs, Tripathi said.

He also noted that the food industry and pathology labs are other possible users of the new sensors.

The researchers said that the sensor can be modified to detect other strains of bacteria by changing the bacteriophage.

The research group is currently collaborating with Security and Protection International, a Canadian company, to explore commercialization of their device.

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