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Slow Rising PSA Concern
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<blockquote data-quote="Nelson Vergel" data-source="post: 49585" data-attributes="member: 3"><p>This is a good summary of factors and variations:</p><p></p><p>"a PSA now stated to be 4.9 ng/ml is most likely the mid point in a range from 3.92% to 5.88 ng/ml. Given this, a second test with a level of 5.2 ng/ml should not necessarily be taken as an increase in levels because it falls within the same range as the first test. The same logic would apply to a second result of 4.2 ng/ml which would not necessarily be a fall in the PSA levels.</p><p></p><p>OTHER PSA VARIANCES</p><p></p><p>Apart from these variances, PSA levels can be elevated by a number of causes, from infection to physical activities. For this reason it is very important to try to establish the cause of any elevated PSA level reported. If the PSA is below 20 ng/ml this should be done before having a biopsy.</p><p></p><p>The most common causes of an elevated PSA are: prostatitis (an infection of the prostate); a bladder infection; or BPH (benign prostatic hyperplasia). This last condition affects most men over 50 years of age and is not deadly. Any infection should be treated before a second PSA test is carried out. Acute prostatitis can cause the PSA levels to rise five to seven times the normal level for up to six weeks or even longer. Both prostatitis and bladder infections are notoriously difficult to treat. There are various natural and pharmaceutical products that may reduce the size of a gland and these may reduce the effect of BPH on the PSA level, as will a TURP (Trans Urethral Resection Procedure). </p><p></p><p>It is recommended that blood for PSA testing should be drawn as early in the day as is convenient and preferably before eating. Constipation and weightlifting are thought to affect PSA levels as does virtually anything that disturbs the prostate gland. Some of the major physical activities which may affect PSA levels and which should be avoided before drawing the blood are:</p><p></p><p></p><p> Sexual activity: Ejaculation can elevate PSA levels for up to 48 hours, or possibly 72 hours, after it has taken place. One of the curious aspects of PSA testing is that it is very rare for this very common cause of variation of PSA levels to be mentioned. If, for example, a test is ordered for cholesterol the doctor will warn their patient that they must fast for 12 hours to ensure the test result is valid. On presenting at the phlebotomist they will be asked if they have eaten anything in the past 12 hours. Yet very few, if any, doctors or phlebotomists will ask men about to have a PSA test about their sexual activities.</p><p> DRE (Digital Rectal Examination). Although doctors often carry out the DRE before drawing blood, they should reverse these procedures </p><p> Cycling or Motor Cycling: This can increase levels up to three times for up to a week, depending on how strenuous the cycling is. This includes an exercise bicycle </p><p> Alcohol and Coffee: Both can irritate the prostate and should be avoided for 48 hours prior to blood being drawn</p><p></p><p>There are many studies that try to evaluate the effect of activities and physical conditions. One such study in Germany concluded that there were seasonal variances in PSA levels and other studies have pointed to the possibility of certain foods and drinks also affecting results.</p><p></p><p>PSA levels can also vary significantly for no obvious reason. One published study shows that of the 295 men in the study who had a first reading of less than 10 ng/ml and who then had two PSA readings within 90 days, only 6% of these men had two identical readings; of the remaining men 46% had a increase or the same PSA on second reading, 54% had a decrease. The largest differences were a reduction of 5.3 ng/ml and an increase of 7.5 ng/ml. The differences are summarized in this table:</p><p></p><p>Percentage of men</p><p>Difference compared to first test</p><p>64%</p><p>Between - 1.0 and + 1.0 ng/ml</p><p>18%</p><p>Between +/- 1.0 and +/- 2.0 ng/ml</p><p>7%</p><p>Between +/- 2.0 and +/- 3.0 ng/ml</p><p>5%</p><p>Greater than +/- 3.0</p><p></p><p>The study stated that these differences might be the result of the mixed effect of random errors, batch inequalities, so-called "physiologic variations" (which I take to mean that no-one has a clue as to why there was such variance!) and transient effects of concomitant prostatitis. "</p><p></p><p><a href="http://www.yananow.org/PSA101.shtml" target="_blank">http://www.yananow.org/PSA101.shtml</a></p></blockquote><p></p>
[QUOTE="Nelson Vergel, post: 49585, member: 3"] This is a good summary of factors and variations: "a PSA now stated to be 4.9 ng/ml is most likely the mid point in a range from 3.92% to 5.88 ng/ml. Given this, a second test with a level of 5.2 ng/ml should not necessarily be taken as an increase in levels because it falls within the same range as the first test. The same logic would apply to a second result of 4.2 ng/ml which would not necessarily be a fall in the PSA levels. OTHER PSA VARIANCES Apart from these variances, PSA levels can be elevated by a number of causes, from infection to physical activities. For this reason it is very important to try to establish the cause of any elevated PSA level reported. If the PSA is below 20 ng/ml this should be done before having a biopsy. The most common causes of an elevated PSA are: prostatitis (an infection of the prostate); a bladder infection; or BPH (benign prostatic hyperplasia). This last condition affects most men over 50 years of age and is not deadly. Any infection should be treated before a second PSA test is carried out. Acute prostatitis can cause the PSA levels to rise five to seven times the normal level for up to six weeks or even longer. Both prostatitis and bladder infections are notoriously difficult to treat. There are various natural and pharmaceutical products that may reduce the size of a gland and these may reduce the effect of BPH on the PSA level, as will a TURP (Trans Urethral Resection Procedure). It is recommended that blood for PSA testing should be drawn as early in the day as is convenient and preferably before eating. Constipation and weightlifting are thought to affect PSA levels as does virtually anything that disturbs the prostate gland. Some of the major physical activities which may affect PSA levels and which should be avoided before drawing the blood are: Sexual activity: Ejaculation can elevate PSA levels for up to 48 hours, or possibly 72 hours, after it has taken place. One of the curious aspects of PSA testing is that it is very rare for this very common cause of variation of PSA levels to be mentioned. If, for example, a test is ordered for cholesterol the doctor will warn their patient that they must fast for 12 hours to ensure the test result is valid. On presenting at the phlebotomist they will be asked if they have eaten anything in the past 12 hours. Yet very few, if any, doctors or phlebotomists will ask men about to have a PSA test about their sexual activities. DRE (Digital Rectal Examination). Although doctors often carry out the DRE before drawing blood, they should reverse these procedures Cycling or Motor Cycling: This can increase levels up to three times for up to a week, depending on how strenuous the cycling is. This includes an exercise bicycle Alcohol and Coffee: Both can irritate the prostate and should be avoided for 48 hours prior to blood being drawn There are many studies that try to evaluate the effect of activities and physical conditions. One such study in Germany concluded that there were seasonal variances in PSA levels and other studies have pointed to the possibility of certain foods and drinks also affecting results. PSA levels can also vary significantly for no obvious reason. One published study shows that of the 295 men in the study who had a first reading of less than 10 ng/ml and who then had two PSA readings within 90 days, only 6% of these men had two identical readings; of the remaining men 46% had a increase or the same PSA on second reading, 54% had a decrease. The largest differences were a reduction of 5.3 ng/ml and an increase of 7.5 ng/ml. The differences are summarized in this table: Percentage of men Difference compared to first test 64% Between - 1.0 and + 1.0 ng/ml 18% Between +/- 1.0 and +/- 2.0 ng/ml 7% Between +/- 2.0 and +/- 3.0 ng/ml 5% Greater than +/- 3.0 The study stated that these differences might be the result of the mixed effect of random errors, batch inequalities, so-called "physiologic variations" (which I take to mean that no-one has a clue as to why there was such variance!) and transient effects of concomitant prostatitis. " [url]http://www.yananow.org/PSA101.shtml[/url] [/QUOTE]
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