High PSA: Prostatitis or Prostate Cancer? | Mark Scholz, MD | PCRI

In this video, PCRI's Alex and Dr. Mark Scholz discuss prostatitis, that is, inflammation of the prostate. Prostatitis can be symptomatic or asymptomatic, transient or chronic, and it can confuse PSA screening for prostate cancer by inflating PSA results. Here, they discuss how it is identified, if and when it is treated, how it is treated, and how it can potentially confuse PSA testing.

0:07 What is prostatitis and how is it interpreted and treated?

2:05 What causes prostatitis?

3:53 How do you tell the difference between prostate cancer and prostatitis when you are tracking PSA, for example?

5:52 If a person's PSA is bouncing up and down from prostatitis, what is the range you would expect? In other words, how high can the PSA go from a prostatitis bump?

8:47 What are the treatments that are available for urinary function?

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The information on the Prostate Cancer Research Institute's YouTube channel is provided with the understanding that the Institute is not engaged in rendering medical advice or recommendation. The information provided in these videos should not replace consultations with qualified health care professionals to meet your individual medical needs.

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[JimMitchell-mo]

I have really appreciated your videos and information provided!! Very helpful in dealing with the confusion and anxiety regarding a high PSA. I'll be meeting with a urologist for the first time this week and feel much more informed about the topic! Thanks again and please continue!!

[paulmaxwell]

Excellent video. I like Dr. Scholz and his straight-forward conversational style. I wish he were my doctor!

[johncashman]

Great presentation … great interviewer

[robertpoole]

So glad I came across this channel, very informative. Here in UK it’s nearly impossible to get psa test, it’s all so contradictory, one group of medics say get a psa test, others say it’s a bit of a waste of time. Very frustrating.

[richardkremmen]

Thanks for this wonderful vid. May I ask: In a case in which man is diagnosed with chronic bacterial prostatitis which only flares up to urinary symptoms every few months or longer, what are the usual treatment alternatives? Is treatment with antibiotics during the symptomatic episodes standard practice? Thanks.

[JFW]

Very helpful advice. I have very high PSA counts, in the 20s. I've had 3 biopsies without finding any cancer and I have no other symptoms. 77 years old UK resident and no trouble getting PSA tested.

[donaldpiper]

I’am glad my doctor sent me too a urologist after my physical this year . My PSA was high, the urologist tested it again and it had raised a few more point’s in just 3 week’s since seeing my primary doctor. I was sent too get an MRI, which indicated several lessons of cancer .I’am now schedule for a biopsy to see how bad it is. I would never have known it, had it not been for PSA test . I hope it’s not too bad, so I’ll find out .

[scoot]

Thank you Both! Extremely Educational Knowledge is Power 💪

[georgemendes]

I've learned a great lot from Alex and Dr. Shultz.i Wish I have found you guys before, this information, is so so helpful ❤

[ayodotunjolaoso]

Please I asked a question about do we need a biopsy to validate if the scan shows bone Mets in prostate cancer

[kt_dallastx]

Does inflammation and prostate cancer look the same on an MRI?

[Dave]

So I've had 6-8 uti's over past couple years. No psa bump. Active Surveillance for one year. Antibiotics, Cipro, took care of it. But what's cause of recurrence? My bicycle shorts?

[stephenpisani]

Hi im 65yrs young and my psa have been 12.4 for the last 14 months, My Urologist sent me for an MRI Scan and results came back inflammation and enlarged prostrate which is the reason for high psa, my Urologist told me i have prostatitis. Im still a little nervouse and asked for a biopsy but Urologist was against the idea as the biopsy needle had nothing to target in my prostrate.
My Dad and Grandad both passed away with prostrate cancer so it does cause a little anxiety.
I had a psa test again during the week 2 months after my last one so im hoping the psa reading has come down🙏🤞🏿 Results next week.

[Allessio]

As a test for Prostatitus (which I suspect since I have Eczema). before my next PSA, could I take Aleve for a couple days prior and see what happens? It PSA drops, then Prostatius more likely?

[scottjackson]

He talks about eliminating cancer to get at a diagnosis of prostatitis. Does that mean that you have to get a biopsy?

[thomash]

I’m wondering about prostate inflammation possibly causing both elevated PSA and a PI-RADS 5/6 (two separate opinions of same MRI). After MRI, I had a random biopsy which showed Gleason 6 (Grade 1) “cancer”. Then I had another MRI targeted biopsy which showed no cancer in the lesion, but did show the same Gleason 6 on a couple other cores Low percentages). I’m thinking active surveillance is best. I will have another PSA check at 6 mos.

Can inflammation cause both a false PI-RADS 5/6 lesion and high PSA?

My prostate is enlarged - and I’m wondering if Gleason 6 tissue is often found in association with enlarged prostates?? (Would be nice to know…)

I’m hoping Gleason 6 / grade 1 gets recategorized at “non cancer” so that I can get back to giving blood. So many things are impacted by this cancer label- including my own psyche!!
Thanks to all….

[daisuke]

So you are in a difficult position if you have prostate cancer and chronic prostatitis at the same time for you can not tell which of them causes a rise in PSA and I find it particularly concerning that no treatment is used to deal with the prostatitis whether or not there is also cancer.

[charlesblumenstock]

A ultrasound will show inflamation and proctitis very well 6:53 6:53 6:53 6:53 6:53

[bbb]

Can chronic prostatitis also affect free PSA?

[chuckharris]

What are risk of sexual side effects and incontinent side effects from simple prostatectomy or other surgical treatments for BPH?