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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18753
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I would like a second opinion to my question. If a man has

Resolved Question:

I would like a second opinion to my question. If a man has a urinary infection and the PSA level is higher than normal. How much higher can the PSA level be with a urinary infection? Is it reasonable to expect pas levels as high as 50? Or is it more likely to be cancer? If it is cancer how advanced would these levels suggest?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.

The PSA can become elevated with a urinary tract infection, although it is thought that the cases with a greater elevation in PSA is due to a spread of the infection to the prostate. There is no stated upper limit for the PSA during an acute infection, as it is directly related to the severity of the infection. However, I was able to find a study that showed elevations of the PSA into the 70s with a acute infection, both with a kidney infection (pyelonephritis) and fever from presumed prostatitis.

See www.ncbi.nlm.nih.gov/pubmed/15264238.

Even this study, though, was only of a relatively low number of patients, so could not be used as defining an upper limit of the PSA, so elevation above the 70s can also occur.

Generally speaking, we are not concerned about any elevation in PSA in a man with an acute urinary or prostate infection. The usual approach is to treat the acute infection and monitor the PSA to be certain that it returns to normal, realizing that it will frequently take several months for the PSA to return to normal.

If I can provide any further information, please let me know.
Customer: replied 2 years ago.
Thank you. I am asking this on behalf of my father. He is a very private person and has never been in hospital. He is 66 years old and now admits that he has known for a long time (years) that there has been something wrong but was too afraid to go.
The doctor conducted a physical examination and said that the prostate was swollen to one side and that he thought it could be cancer.
If this was the case, is it possible to cure or treat and how likely is it to have spread?
My father has been tired for so long but retired and no real explanation for this, he has had the water infection for years but now it has come to a head.
I know without seeing him you are limited to how you respond. The first doctor I spoke to was great but I would like a second opinion.
Expert:  Dr. D. Love replied 2 years ago.
First, the swelling on one side could easily be due to infection affecting the prostate, in the same way that tonsils can be swollen more on one side when there is an infection of the tonsils.

If he has other signs of infection, it is most likely that the swelling and elevation in PSA are due to infection and not from cancer. If he had a previous PSA that was normal, that also would support that everything is due to an infection rather than cancer, although it sounds like he may not have been seen previously to have had a prior PSA checked.

If the swelling and PSA does not return to normal with antibiotics, then it would then be a concern that it is from cancer. The likelihood that it is cancer would depend upon the severity of swelling and the extent of PSA elevation at that point. For example, if there continues to be swelling and a PSA of 10, there is about a 40-50% chance that there is cancer that will be detected, depending on other risk factors. However, if the PSA is still 50, then there is about a 70-80% chance that cancer will be detected.

Note that even with a very high elevation of 50 after the infection is treated, 20-30% of men will not have cancer.

The likelihood of successful treatment would depend upon the extent of the cancer when detected, but the prognosis is good for the vast majority of men in whom it is detected while still limited to the prostate.
Customer: replied 2 years ago.
Thank you
Expert:  Dr. D. Love replied 2 years ago.
You’re welcome.

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