If your doctor mentioned that your PSA is elevated, you might be worried about what that means. Prostate-specific antigen (PSA) testing often raises concerns about cancer. However, there’s an important connection many men don’t know about: benign prostatic hyperplasia (BPH) commonly causes high PSA levels without any cancer present.
Understanding the relationship between BPH and high PSA can help reduce unnecessary anxiety and feel better about managing your prostate health.
What is PSA?
PSA, or prostate-specific antigen, is a protein made by cells in the prostate. Normally, only small amounts enter the bloodstream. Because both healthy and abnormal prostate cells produce it, PSA can rise for many reasons.
How Does BPH Affect PSA Levels?
While PSA is often discussed in connection with prostate cancer, it is not a cancer test; it is a prostate activity test.
As men age, the prostate naturally tends to enlarge. In BPH, this growth becomes more pronounced. The term benign means non-cancerous, and hyperplasia means an overgrowth of normal prostate cells.
A simple blood test that measures PSA levels is used to evaluate prostate health. A rise in levels does not mean cancer is present. It can also reflect increased gland size or irritation. Since the gland is larger, there are simply more cells making PSA, which means more of the protein can enter the bloodstream.
BPH-related PSA changes usually occur gradually over years. Watching the rate of change often helps doctors determine whether the increase looks benign or concerning.
On the other hand, some factors can lower PSA levels, including medications that shrink the prostate, like finasteride or dutasteride. For that reason, doctors always interpret PSA results in the context of your history and medication use.
How Do Doctors Tell BPH from Cancer?
Because PSA levels can rise in both benign and cancerous conditions, doctors use a combination of tools in prostate cancer screening rather than relying on one number. Additional PSA markers, such as PSA relative to prostate size and the free-to-total PSA ratio, can help refine the risk assessment.
Other tests include:
- Digital rectal exam (DRE). The doctor feels the prostate through the rectum to check for firmness, nodules, or irregular shape.
- PSA trend over time. A steady, slow increase is more typical of BPH, while a faster or unpredictable rise can signal something more serious.
- Imaging tests. Ultrasound or multiparametric MRI provides a closer look at prostate size and structure.
- Biopsy. Obtaining a tissue sample is helpful for directly checking for cancer cells.
It’s also important to note that BPH does not cause prostate cancer and does not turn into cancer, though the two conditions can exist together.
BPH and High PSA
If your PSA elevation is believed to be due to BPH, the goal is to manage urinary symptoms rather than treat the PSA number itself. Treatment may include:
- Medications that relax or shrink the prostate, improving urine flow
- Lifestyle changes such as limiting caffeine, reducing evening fluids, and maintaining a healthy weight
- Minimally invasive procedures or surgery if medications are not effective or if urinary retention develops
BPH and PSA are closely connected because a larger prostate naturally produces more PSA. Most men with elevated PSA and urinary symptoms have benign enlargement rather than cancer. You should contact your doctor if you notice:
- Difficulty starting or stopping urination
- A weak or interrupted stream
- Frequent nighttime urination
- Pain, burning, or blood in the urine or semen
A simple evaluation, including a DRE and PSA test, will help identify the cause of your symptoms and rule out more serious conditions.
Get Expert Advice About Prostate Health
Don’t let concerns about BPH and high PSA keep you up at night. While an elevated PSA level can be unsettling, it’s often a sign of BPH rather than something more serious. The key is getting an expert evaluation of your prostate health.
Schedule an appointment today to learn more about BPH and high PSA in Clive, IA, and the Des Moines area.