I am 59, male, with a high PSA level. Is it prostate cancer?

Question

Hello doctor,

I am a 59-year-old man who has been having trouble with urination, including a weak stream, frequent nighttime trips to the bathroom, and a feeling that my bladder is not completely empty. My recent PSA blood test came back elevated at 8.2, which my family doctor says is concerning and requires further testing.

My father was diagnosed with prostate cancer at age 65, and my older brother had an elevated PSA (prostate-specific antigen) that turned out to be benign. I am anxious about the possibility of cancer, but also confused about what these symptoms and test results mean. Could these urinary symptoms be related to the elevated PSA, and what are the chances that this could be cancer versus a benign condition?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

At 59, experiencing urinary difficulties such as a weak stream, frequent nighttime urination, and a sensation of incomplete bladder emptying, along with an elevated PSA level of 8.2, warrants further evaluation because these symptoms and test results can be caused by several conditions. While prostate cancer is a possibility, especially given your family history, which increases your risk, benign causes such as benign prostatic hyperplasia (BPH) or prostatitis can also elevate PSA and cause similar urinary issues.

PSA (prostate-specific antigen) levels above four ng/mL (nanograms per milliliter) are generally considered higher than normal, but they are not specific to cancer, meaning many men with elevated PSA do not have prostate cancer, and some men with prostate cancer can have normal PSA levels.

The next step usually involves repeating the PSA test, possibly performing additional tests such as a free-to-total PSA ratio, MRI (magnetic resonance imaging) of the prostate, or a prostate biopsy to confirm the diagnosis. While your symptoms may be related to prostate enlargement rather than malignancy, it is important to proceed with the recommended investigations so that if cancer is present, it can be detected at an early and more treatable stage. Please share the results so I can help you accordingly.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.