On screen, drawing illustrating the prostate (without pathology).

HIGH PSA From a Large Prostate: It Can Happen

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:

“Hi Peak,

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.

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