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A friend of mine is 65 years and has an enlarged prostate. His PSA over the past 2 years has increased from 4.5 to 7.2. His doctor thinks he should see a urologist. Does a person with an enlarged prostate have a tendency to have a higher PSA ? The DRE he received from his physician seemed alright....although of course the urologist will subject him to a more thorough one. Should he be overly concerned? Thanks.
First, as others have said, an enlarged prostate DOES cause a higher PSA reading. The prostate (and, I believe, the Cowper\'s glands) are the only sources of the PSA protein in the blood. Essentially it is prostate tissue that creates PSA. The larger the prostate -- hence MORE prostate tissue -- the higher the PSA.
In my case, I had a severe case of BPH (enlarged prostate -- a benign condition). My PSA had also gone up to 5.7 or 6.4, depending on which lab being used. While the BPH may have been enough to justify the higher PSA, my uorologist also stressed that it could also be masking the presence of a prostate tumor.
Turns out he was right. I was lucky that it was a low-risk Gleason 6 tumor, but I still opted for surgery to eliminate both the cancer AND the urination problems I had been having.
So, it would definitely be wise for him to visit a urologist.
ONE CAUTION THOUGH: It would also be wise to have the expected new PSA test taken BEFORE the uro might perform a DRE (digital rectal exam). In fact, in the 2-3 days before the blood draw, do NOT: have sex, ride a bike, do strenuous exercise, have a DRE, etc. Anything that stresses the prostate can put a temporary spike into the PSA -- and he will want as true a reading as possible.
Thanks for the advice Chuck. I'll let Jeff know what you said. Yes, I also had my Prostate yanked in spite of having only a Gleason 6 - and they found Gleason 7 in the post surgery analysis. I'm very glad that I chose a treatment and took care of business and moved on. Some of my buddies went the "AS" route but it basically only bought them a few extra years - and a bunch of additional stress - before surgery was necessary.
