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Borderline PSA with MRI Scheduled

I really don’t want to minimize what others on this forum are going through, have experienced, etc. I know there are guys who are in much worse shape than me, but this is my first “real” health scare and all the searches I’ve done seem to end up coming from this forum. First of all, I’m 53. I run 5 times a week (about 35 miles), lift twice a week, and do yoga 2-3 times a day. I was a marathoner for years, blew my back out and got into powerlifting and testosterone supplementation (I didn’t need it — I just wanted some help in the gym.) My PSA went up when I was on it, but I knew that it was likely a false reading due to supplementation, so I blew it off. I haven’t taken any testosterone since late 2023 since I’m running and competing again, and I have to be clean for drug tests. I went for a physical the other day, and my PSA was 4.12. The PA said it was abnormal and scheduled me with a urologist. I had been constipated, having weak streams (sometimes), and frequent urination, but I chalked that up to increased mileage (10-12 mile long runs) and their effect on my pelvic floor. I read that it could’ve been a false reading since I had a very intense tempo run two days before, sex two times the day before, and did some intense yoga the morning of the test. The urologist did another PSA a week later. I had no sex and didn’t run for that week. The reading came back 4.01. She did a DRE during the same appointment as my blood draw for that second PSA and said that the right side of my prostate was larger than my left. I’m scheduled for an MRI in about 3 weeks, but I’m kinda freaked out. Some friends are saying BPH, but everything I’m reading always tends to the worst case. I know this may seem shallow with all some of you have going on, but it is what it is. Below are my readings. No family history or PC. Heart disease is what gets us. I’d like any advice, anecdotes, or whatever about what to expect coming up.

  1. Hi . It is completely understandable to be concerned about the PSA test and a prostate exam where the doctor believes they felt something - not minimizing at all. It is good that you came to a place you can get information and support. I will say that on the internet you will often read the worst case scenario stories. People don't share near as often when everything turned out fine. You are absolutely correct that vigorous exercise can raise PSA levels (see here for an overview of the PSA test, including some of the things that can raise it: https://prostatecancer.net/diagnosis/psa-test). It is good that you are getting the MRI. It should give you some answers on whether further steps are necessary and, if so, it is better find out early. I can also tell you that research has found that it is usually nodules that are the biggest potential indicator of prostate cancer from the DRE and that asymmetry is not necessarily an indicator (see: https://intbrazjurol.com.br/pdf/vol42n04/Yilmaz_704_709.pdf). Hoping you get some answers soon and please feel free to keep us posted on how things are going. Best, Richard (Team Member)

    1. Thank you for your response.
      I have moved my MRI up to a closer date — next week.
      We’ll see…
      Thanks again!

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