One of the Peak Testosterone Forum members has struggled for quite awhile with high PSA values. We all know by now that the PSA is anything but perfect as a prostate cancer test, because its elevation can be caused by a number of things: a) prostate cancer, b) BPH (enlarged prostate ) and c) inflammation. In fact, inflammation is the most common cause actually.
What I want to cover on this page is that there can also be a fourth reason for a high PSA: a large prostate. That's right - some guys just have big prostates, and it is something to be aware of as your prostate readings will come out higher than normal more than likely.
The member I mentioned above wrote in and explained that this is exactly what happened to him and it caused him a lot of stress. Finally, a knowledgeable doctor pointed out that this was probably his issue. Here is what he wrote me:
I haven t communicated in a while but been extremely busy. My PSA has been fluctuating between 5 and 12 for the last year and a half, so my Urologist wanted me to get another MRI on my prostate. (As you know I m against biopsies.) I was reading recently a blog written by this guy - Mark Scholz - and found this article he wrote called PSA Screeing for Prostate Cancer. I m going somewhere with this, so bear with me.
When I had my MRI done about 2 years ago my prostate size is very large, 130cc. Using the formula in this article a normal PSA for me would be as high as 13. I even had this confirmed by a very famous prostate cancer doctor this week at University California Irvine said my PSA was normal considering the size of my prostate, he took a look at the Radiologist report from my MRI.
I m blown away that no doctor I ve seen, even several urologists, have commented on the size and density of my prostate in relationship to my PSA. I have to believe that a lot of it is money. I million biopsies a year at $4,400 is a lot of money. I hope all is well and I thought you might find this very interesting."
Yes, I did find it interesting and put it on my site in the hopes that the word will get out. Of course, don't just assume that, if you have a raised PSA, your a big man down under. Find a good doctor and work with him. (I say 'him,' because I've never heard of a female urologist. If there is one out there, I take it back.)
In my case, I had a relativey small prostate (25-30 cc which is in the normal range actually) and so I couldn't blame an elevated PSA - it got up to 6.3 at its peak - on that. You can read about my struggles with this here: High PSA But No Cancer. Also, keep in mind there is an quite accurate test - much moreso than the PSA - for detecting the aggressive form of prostate cancer, which is what you really care about. I actually took this test and discuss it here: The 4kScore Test.