my situation is similar to yours, tho without the infection. i had a PSA of 2, then 4, then 5, and then a biopsy. so, first, the MRI, and then the biopsy for the cancer that was almost certainly there. then, oops, no cancer (which was a good oops). then, 3 years later, PSA is now 10. another MSI, another biopsy, another clear result. so you never know. very possibly i've got cancer in there, but the doctor keeps not finding it, which is sort of the cancer version of "pics or it didn't happen."

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Dan Empfield
aka Slowman

My n+1 experience is that my doctor told me that "stopping" riding would not change my PSA score. After being diagnosed with prostate cancer via the biopsy and having a low Gleason score I opted for active surveillance where I had the PSA test every six months for several years. IME nothing (biking, sex) except cancer changed the PSA score. I feel for you about getting the biopsy. That is one uncomfortable procedure. Whatever you do stay on top of the issue. Prostate cancer if left untreated is no joke. I ended up having my prostate (and cancer) surgically removed in '16. Was only off the bike for about 3 months. First year I could always feel a sensitive spot if I sat wrong on the seat. After that no problems and more comfortable on a bike seat that I was before the surgery.

That is very helpful--thanks! Looking at the limited medical research suggests that suspending cycling wouldn't change much (except for immediately before a test) and would certainly make me very grumpy.

PSA although not a gold standard goes up for a reason...ie irritation, cancer or enlargement. If it keeps going up keep checking on it. Denial is not only a river in Africa, stay aware of changes and keep a sharp eye out. If it is the big C and stays in the prostate not a biggie, if it gets out, it can be a huge problem. You and your Urologist are a team, stay in touch.

When my father was going through treatment for PC, I asked the same question to his rad oncologist who specialized in treatment for PC. He basically said jury is out, but to be on the safe side he recommended avoiding biking (and sex) for 2 - 3 days before a PSA test.

I have active low grade PC (Gleason of 6, age 59) and my PSA over the past four years since diagnosis, regardless of cycling activity, comes in the 6-7 range. I hold off on sex a few days prior to bloodwork. Dr doesn't think there's a great deal of impact to make a difference so I don't limit my saddle time. I do not want to get my prostate taken out, but realize this damn thing is cancer and will if I have to. Good luck to you, just remember that there are lots of treatment options out there and this thing will not take to you out.

Just had a prostate infection 5 weeks ago, high fever, urinary issues. I had a baseline PSA of .3 in 2018, with the infection I was at 2.33. I was started on 4 weeks Bactrim, all told I was off the bike 3 days, when infection cleared I did a few days of very easy short rides. One week after the infection I was feeling better and started my regular riding schedule of 5 days 7-8 hours per week. As a precaution I switched saddles and put my ride bike saddle with a cut out on the trainer. By accident I had another PSA done with some other unrelated labs a week after the infection and it had dropped to 1.7. I kept riding over the course of the antibiotics and just got another PSA and was at .49 so in my case the riding doesn't seem to have prevented the PSA from dropping.

Right, riding a bike won't 'prevent' a PSA from dropping when being treated for an infection. The question is really, will riding a bike give a reading that is higher than it would have been if you hadn't gone riding.

Your .49 reading may have been lower had you not been riding. That said, it really doesn't matter, PSA itself is not harmful. Its just an indicator. And to get accurate baseline and comparison readings, its a good idea to not do anything that -might- cause it to rise right before a test.

Slowman - just a guess from someone who is not a doctor... :) If your PSA is rising, and all tests come up negative for cancer and no infection, then I'd say you have BPH, which is not an infection and -can- cause PSA to go up. Again, just a guess!

I was riding my bike when I got the baseline so it probably makes for a better comparison to be riding now. My only point is that in my particular case riding didn't prevent my PSA from declining back to baseline after an infection.

Radiologist here . PSA from 2 to 10 is concerning . Biopsies are random and can miss significant disease. MRI is very useful , but it should be a 3 T magnet , done with contrast and interpeted by a rad with specific prostate imaging training.
Bike riding / sex within 48 hours of a PSA can elevate the result possibly up to 10 % .

Most of your question has been addressed in other replies. I suspect quite a few of us have experienced the frustration of dealing with prostate disease and prostatitis while trying to continue training. I've had my own adventure, that is ongoing now for 2 years, with it. I have chronic infection in the prostate of mysterious origin which then spreads to the bladder and surrounding tissues if left untreated fairly quickly. The specific bacteria is well known to exist in the gut (klebsiella pnuemonae) but wreaks havoc when it gets outside of that environment. I've been on antibiotics more than I haven't been over the past 2 years. They've started to take a toll on my body in various ways - including an onset of lower back pain that is now my constant companion. I've been through an incredible battery of tests, scans, imaging and exploration to identify the source - and thus far no smoking gun. Meanwhile I've continued to train and for the most part it has been possible to do so without interruption or discomfort. I did have to discontinue riding, running and swimming during a month long round of infusion since I had a PIC (central line) in my arm - and daily trip to the hospital for the infusion at the chemo center. This sucked and it caused a lot of fatigue but I continued working through it. Lots of cystoscopies (camera to the prostate and bladder through the urethra) and CT cystogram were also no fun. As a few people have mentioned, there are numerous things that elevate the PSA. My docs have been telling me not to focus or worry about the PSA number so much. They have done multiple MRI's, CT scans and ultrasounds, biopsy and colonoscopy and the other tests all of which have been negative for cancer.

I ride an ISM PR 2.0 40mm on the tri bike, Fizik Aliante R1 on the endurance road bike and Specialized Phenom Expert on the road bike in the Wahoo trainer. I haven't found any of then to be problematic in terms of exacerbating the problem. But my prostate is not terribly enlarged as is the case with many who face such issues. The docs tell me it's very normal sized for my age (mid 50's).

I share my own medical situation in hopes that as other men who face similar issues may be able to learn from each other and perhaps be able to provide additional insights to each other and our doctors. As you have no doubt discovered, the prostate is one of the most protected organs of the body and its remarkably difficult to reach with antibiotics or other therapies.

I wish you each luck in recovery of your various conditions. My decision is to continue training and competing in age-group events as long as I'm able. I lost last season to covid, as we all did, and the season before that to the 30 rounds of infusion therapy. So i've done a lot of training for events that i haven't been able to compete in. Here's hoping this summer is different for all of us.

Thanks for the input. It is an encouragement to keep plowing ahead with training. Cycling does keep me grounding, even during a very discouraging season last year.

Here's hoping for improvements and continuing above all else!

I’m going thru this now. Just out of the blue, I started having a little more trouble with urination, and then got fever/chills and just didn’t feel good. Started antibiotics on Friday night (so, 36 hours ago) and feel a lot better overall but still having problems with urination. I feel like I cannot urinate completely and my stream is weak. Also, “urgency” where I feel like I have to go…NOW!!! I was really hoping these symptoms would be better after 36 hours of antibiotics but I think I was being too hopeful. Did it take a week of antibiotics for your urinary symptoms to go away (or feel back to normal again)?

Troutd0g, thank you for sharing this info. What you describe is a big fear of mine. Of course, once I was diagnosed with prostatitis, I started reading about it and how it can turn chronic. I haven’t been to a urologist yet but it would be interesting to know if they would ever consider taking out your prostate for such a relentless chronic condition?

I would say a week is about right, probably a little less, but the worst of it had already passed by the time I started the anti-biotics. My course was: started feeling weak on Wednesday afternoon, Wednesday night and all of Thursday were awful, Friday was already feeling better, went to the doctor and started antibiotics, Saturday and Sunday feeling better did Z1 rides, Monday did mostly Z1 with a few efforts, Tuesday felt about 98% and did a hard ride and by Wednesday or Thursday was feeling normal and back into regular routine.

More likely that you are among the majority of males with a high PSA and no cancer, many of whom are subjected to unnecessary biopsies.