Figure 4.

Prostate-specific antigen (PSA) levels in a 55-year-old man with stable, low values until he returned at age 62 years with a mild increase in voiding symptoms over the past several weeks. Results from digital rectal examination and urinalysis were normal. PSA evaluations showed a marked increase to 9.1 ng/mL from earlier levels. His prostate cancer antigen 3 (PCA3) score was 22.5 (and 6.2 on repeat test), levels suggesting absence of cancer. With antibiotic treatment, PSA declined, and biopsy was deferred. Acute or subacute prostatitis, with symptoms ranging from severe to mild, may elevate serum PSA levels for months, confounding the utility of serum PSA level as a cancer marker.