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Dr. Robert
Dr. Robert, Doctor
Category: Medical
Satisfied Customers: 6680
Experience:  M.B.B.S, Experienced Family Physician
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I have recently had a routine psa test which resulted in 7.9.

Customer Question

I have recently had a routine psa test which resulted in 7.9. My last test ten years ago was 2.9. I am 61 years old and have no urinary symptoms but have difficulty ejaculating which I have been told is probably due to my medications for sero negative arthritis. I inject myself every week with Metharexate. Now I have discovered Methatrexate could influence my psa result. I have been asked to have a biopsy next week and now don't know whether to go ahead with it. What do you advise?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Robert replied 4 years ago.
Welcome to and thank you for your question.
I'm so sorry to hear of your discomfort.I will do whatever I can to help answer your questions:

Methotrexate is a chemical compound often used to suppress the immune system in order to treat certain diseases. It can also lead to altered PSA levels.

PSA stands for prostate specific antigen. It is often used as a screening test to detect prostatic cancer.

Methotrexate can interfere with the PSA test.

Those with a PSA between four and 10 have a 25% chance of having prostate cancer and if the PSA is higher than 10, the risk increases to 67%.

Higher PSA does not always indicate for prostate cancer.If a higher than normal level is found, it may be an indication of prostate infection, inflammation, enlargement or cancer.

Although you do not have any urinary symptoms,but considering your age factor & high PSA levels(most probably due to methotrexate),you should have the following tests:

-Digital rectal examination (DRE),
-PSA velocity.
-Rectal ultrasound
-Prostate biopsy,
-Urine flow
-Percent-free PSA.

As you have already underwent -Digital rectal examination (DRE) & MRI scan with normal reports,further a prostate biopsy if done will make you sure 100% safe & will rule out the cancer.So I advice you to go for the prostate biospy.A prostate biopsy is the best test to detect/rule out prostate cancer.

Hope this helped.

My goal is to provide you with excellent service – if you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Thank you

Kind Regards,
Dr. Robert