# Prostate Specific Antigen slightly elevated: From MTBing?



## Prognosticator (Feb 15, 2021)

I did a search but couldn't find if this has been addressed.

I had my annual blood work done and my PSA is slightly elevated. It's supposed to be below 4.0. 

On 7/15, it was 4.30. They did the test the day after a ride. My doctor called and asked me if I had been riding. Then he said he wanted me to stay off the bike for two weeks and get retested.

Well, staying off the bike for two weeks is not great for my mental or physical health. Also, riding here in NEGA has been slim pickings because we have had such a rainy July. So, I didn't stay off the bike for two weeks. More like a week. Got retested and it's 4.09.

Since it's borderline, he wants me to see a urologist.

I know from other guys what these urology appointments can be like, and I'd like to avoid that experience if I can.

With that being said, has anyone else experienced a slightly elevated PSA attributed to MTBing? If so, how elevated was it? Did you go the urologist route? 

Any input would be appreciated.


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## FitmanNJ (May 23, 2011)

Prognosticator said:


> I did a search but couldn't find if this has been addressed.
> 
> I had my annual blood work done and my PSA is slightly elevated. It's supposed to be below 4.0.
> 
> ...


If I recall correctly, I had a PSA test done early this year (rode the prior day) and the result was about 4.5; I retested after taking a week off the mtb (first time I ever did that) and the PSA was about 1.8. I had heard that cycling _could_ cause an elevation, but I had no idea that it could be that dramatic...at least in my case. A second test with a week off the bike has yielded a similar PSA result. It's important to note that I'm on Finasteride, which tends to halve one's PSA test result, and been under the observation of a urologist for what we think is benign prostate hypertrophy (BPH). An MRI I had done of my prostate a year ago showed no suspicious masses.


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## Prognosticator (Feb 15, 2021)

Thanks for this info. So, without the Rx your PSA with the MTB pause would be 3.6 and without the MTB pause would be 9.

My result did not vary that much. Only .21. I have an appointment with a urologist in a few weeks to see what he says about the number. Hopefully he will know more about the impact of being on the bike. The tests were ordered by my GP.

Could luck with your prostate health.


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## LanceWeaklegs (Dec 24, 2019)

Let me understand. The issue is prostate cancer. The worst type of treatment any man could ever imagine, possibly with lifetime “side effects”. And that’s if the cancer is not metastatic which is a whole different set of nightmares. And with this at stake, you couldn’t not ride for two weeks? As a cancer survivor (not prostate) I am without words. other than those I just typed in. And, a physical prostate exam that could save your life or rule out cancer is so yucky you wasn’t do it? Yikes.


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## FitmanNJ (May 23, 2011)

Prognosticator said:


> Thanks for this info. So, without the Rx your PSA with the MTB pause would be 3.6 and without the MTB pause would be 9.
> 
> My result did not vary that much. Only .21. I have an appointment with a urologist in a few weeks to see what he says about the number. Hopefully he will know more about the impact of being on the bike. The tests were ordered by my GP.
> 
> Could luck with your prostate health.


Doubling the non-Rx value (for Finasteride) is a "rough" guideline, but it's widely used. I think you have my numbers right. I was very relieved that the PSA value was that much better after the "pause"...although surprised at the magnitude of the change. I think my latest measurement (again done after a "pause") was 1.58 (so ~3.16, adjusted).

It will be interesting to see what your urologist says. I'm not sure how widely the "bike saddle" affect is acknowledged or how consistent the difference is (I haven't found a lot of reliable analysis online). I also don't know whether this difference would be expected in all men (I suspect not or you'd think it would be better documented).

Thanks for the kind thoughts...I hope the news will be good for you, too!


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## Dkayak (12 mo ago)

My PSA runs about 1.5 each year. A few years back I had my annual physical a couple days after a very rough gravel ride and knew I’d inflamed my prostate, based on pain I recognized from issues 30 years earlier. I blame the recent inflammation on a very old saddle whose padding had collapsed so it got jammed up into places that normally get no contact.

My PSA was about 12 IIRC. My Doc understood the likely cause, we agreed I’d take a 10 day break, retest, and it came back about 2.5. Every year since it’s been about 1.5 or so. No more soft saddles! I immediately replaced the broken down one. Now I develop callouses over my sit bones and the soft tissues ride high above the saddle. I also set it slightly nose down. Good luck!


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## Prognosticator (Feb 15, 2021)

LanceWeaklegs said:


> Let me understand. The issue is prostate cancer. The worst type of treatment any man could ever imagine, possibly with lifetime “side effects”. And that’s if the cancer is not metastatic which is a whole different set of nightmares. And with this at stake, you couldn’t not ride for two weeks? As a cancer survivor (not prostate) I am without words. other than those I just typed in. And, a physical prostate exam that could save your life or rule out cancer is so yucky you wasn’t do it? Yikes.


To reiterate what I said in my previous post: I'm seeing the urologist.

If he wants to perform the exam, of course I will do it.

It's not uncommon for people to weigh the options and gather all the data possible in deciding whether to have a medical procedure. In fact, I would argue that only an idiot with little regard for his health would just go ahead and agree to a medical procedure without doing some research.

I am sorry for your struggles. Please respect my concerns.


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## Dkayak (12 mo ago)

Prognosticator said:


> To reiterate what I said in my previous post: I'm seeing the urologist.
> If he wants to perform the exam, of course I will do it.
> 
> *It's not uncommon for people to weigh the options and gather all the data possible in deciding whether to have a medical procedure.* In fact, I would argue that only an idiot with little regard for his health would just go ahead and agree to a medical procedure without doing some research.
> ...


An old buddy had high PSA about 5 years ago and was referred for a complex biopsy that used multiple needles to “map” his prostate. He was given an antibiotic in advance because bacteria can be dragged in with the needles and was was warned there was still a small chance of infection and even death. He developed an infection and a terrible fever, was hospitalized, put on a bed of ice, had his blood pressure drop into the 40’s, nearly died, and developed AFib. The biopsy came back negative. Still no signs of prostate cancer either.

When I had my PSA spike a couple years later (described above), my buddy encouraged me to wait, retest, and accept the biopsy only as a last resort. I did promptly see a urologist, who did an exam but agreed with my Doc that the wise course was to take a break from cycling and retest PSA. No invasive procedure is risk-free.


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## LanceWeaklegs (Dec 24, 2019)

Prognosticator said:


> To reiterate what I said in my previous post: I'm seeing the urologist.
> 
> If he wants to perform the exam, of course I will do it.
> 
> ...


Don’t mean to disappoint you but I dont have any struggles. And a digital prostate exam is about as light as a ”medical procedure“ as it gets. Most men over 50 get one every year. I had to have one for work every year with my physical. didnt exactly look forward to it, but if something is there they’ll feel it. as far as respecting your concerns, if you wouldnt take two weeks off from riding at your doctors request you probably aren’t too concerned about anything.


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## Smokee300 (Jul 8, 2014)

I'm 56. Last year I had my annual physical with a digital exam and PSA. I did about a 10 mile, medium/light rocky ride an hour before the physical. My PSA came in at 1.7 whereas it was 1.1 the prior year. My GP said the overall test was within acceptable parameters but the year over year increase warranted another test, 3 weeks later, another PSA, back to 1.1 My GP says Great, but...go have a talk with a urologist just for cautions sake. I explained the ride to the urologist and he said, he tells clients no biking 3 days prior to a PSA and ideally no sex/ejaculation. Another PSA done 6 month later and still 1.1.


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## Prognosticator (Feb 15, 2021)

Thanks. Interesting that your doc said no riding for three days. Mine said no riding for two weeks. No telling who's right. Regardless, mine seems high compared to others sharing on this thread. I'll learn more in a few weeks.


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## Smokee300 (Jul 8, 2014)

Prognosticator said:


> Thanks. Interesting that your doc said no riding for three days. Mine said no riding for two weeks. No telling who's right. Regardless, mine seems high compared to others sharing on this thread. I'll learn more in a few weeks.


Also, my GP, who I like, and I'd say is very he's very knowledgeable, didn't really know much about the correlation between biking and the elevated PSA level. The urologist was very aware.


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## Rev Bubba (Jan 16, 2004)

My PSA was "slightly" elevated because I had prostate cancer. That was about 15 years ago when I was 58. 

My GP found the issue during my annual physical and he referred me to our family urologist who waited a few months to see if the levels dropped. They didn't so the next step was a biopsy. That confirmed the cancer. It wa stage 1 with a low Gleason Score. I was not going to die immediately. My wife, an RN, and I discussed it and I opted for a radical prostatectomy. 

End of story, I'm cancer free, ride way over 100 days a year (166 last year) and am around to enjoy my granddaughter.

There were some comments about riding but nothing that said don't ride but that was 15 years ago. My GP is an avid roadie. My urologist does not ride. 

Good luck.

PS: Someone mentioned "side effects." Referring to sex of course. My wife and I have sex every week and I'm 73. So much for "side effects." Death is a much worse side effect.


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## Prognosticator (Feb 15, 2021)

Rev Bubba said:


> My PSA was "slightly" elevated because I had prostate cancer. That was about 15 years ago when I was 58.
> 
> My GP found the issue during my annual physical and he referred me to our family urologist who waited a few months to see if the levels dropped. They didn't so the next step was a biopsy. That confirmed the cancer. It wa stage 1 with a low Gleason Score. I was not going to die immediately. My wife, an RN, and I discussed it and I opted for a radical prostatectomy.
> 
> ...


Thank you for your this info. Great to hear.


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## jokermtb (Mar 11, 2004)

Prognosticator said:


> I did a search but couldn't find if this has been addressed.
> 
> I had my annual blood work done and my PSA is slightly elevated. It's supposed to be below 4.0.
> 
> On 7/15, it was 4.30. They did the test the day after a ride. My doctor called and asked me if I had been riding. Then he said he wanted me to stay off the bike for two weeks and get retested.


Keep in mind, a blood test is a snapshot in time. Take 4 blood tests over 24 hours, and each one will show you something different. A doctor can never be quite sure, as infinite blood tests would be needed....


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## Cary (Dec 29, 2003)

LanceWeaklegs said:


> Let me understand. The issue is prostate cancer. The worst type of treatment any man could ever imagine, possibly with lifetime “side effects”. And that’s if the cancer is not metastatic which is a whole different set of nightmares. And with this at stake, you couldn’t not ride for two weeks? As a cancer survivor (not prostate) I am without words. other than those I just typed in. And, a physical prostate exam that could save your life or rule out cancer is so yucky you wasn’t do it? Yikes.


Count me in as agreeing. Go see the urologist. If you have prostate cancer you have caught it early and your treatment options and potential outcomes are good. Wait and those options decrease along with your likelihood of beating it. A few minutes of discomfort with the urologist is far better than battling advanced cancer or worse yet, the prolonged and painful death that comes with it.


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## Skymonkey (Mar 12, 2014)

Sitting on my couch reading this thread 6 days post-op from a nerve sparring radical prostatectomy. I'm 61, in excellent health and avg road/MTB rides 4 days week most of the year. My PSA was slightly elevated at 4.2 during routine blood labs with my primary care physician. Went to see my urologist a week later who took another PSA. Came back at 4.2 again. He put me on 7 days of antibiotics (in the event it was prostitis), stayed off the bike then retested again...same results. Doc didn't like what he was seeing...my last PSA test in 2019 was 1.7. Next stop was an MRI which showed concern. Next was a biopsy which came back with positive cancer results. Gleason score of 7.

Bottom line, don't mess around and get into see a urologist if your PSA levels are even slightly high. Mine was caught early and fortunately hadn't metastasized. I elected to take my chances with the possible side effects of the surgery and get the cancer out of my body. If I happen to leak or not get wood again as a consequence then I'll deal with it. At least I'll be alive.


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