Have a patient with a moderately elevated prostate specific antigen (PSA)? Do not freak out!
To many providers are trigger happy with referrals, especially with an elevated PSA.
Take a deep breath and simply recheck it in 6 weeks. That is what many urologists are going to do anyways.
Go ahead and get the appointment set up considering there is likely a 6-8 week wait list. Before they go to the appointment though, recheck the PSA.
I have seen PSA’s at my men’s health and testosterone clinic be in the 4-5 ng/ml range and then when I recheck it 6-8 weeks later it goes back down to 2 ng/ml. An increased PSA can be transient and associated with something as simple as riding a bike.
If the PSA is in the 4-7 ng/ml range, recheck it in 6 weeks. If it is over 7 ng/ml though, refer it out to urology.
If the patient is on a 5-alpha reductase inhibitor and the PSA elevates, send it to urology regardless. This has been associated with an elevated risk of prostate cancer.
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2 Responses
This is so true. I would also add that if a gentleman is having an acute urinary problem such as acute retention, UTI, etc that is not the time to be checking PSA levels. They will be elevated every time.
Yep. I see transient increases in PSAs all the time as I check it everytime I check labs on my mens health patients.