High PSA in Melanoma Patients: What It Means and Should You Worry?

A high PSA (prostate‑specific antigen) level generally points to a prostate issue rather than melanoma. PSA is a protein made by the prostate, and its level can rise for several non‑cancer reasons such as age, benign prostate enlargement, inflammation, infection, or recent prostate manipulation. ^[1] Most men with an elevated PSA do not have prostate cancer, so a single high result is not proof of cancer. ^{[2] [3]}

What PSA Measures

• PSA is produced by prostate tissue and circulates in the blood; it is not a melanoma marker. ^[1]
• PSA can increase with prostate cancer, but also with benign prostatic hyperplasia (BPH), prostatitis (prostate inflammation), urinary infections, certain medicines, ejaculation, or procedures like catheterization, biopsy, or surgery. ^{[1] [4] [5]}

Does Melanoma Raise PSA?

• Melanoma does not typically affect PSA because PSA is prostate‑specific. ^[1]
• If a person with melanoma has a high PSA, the elevation is more likely related to the prostate (benign or malignant) or recent activities/procedures, rather than melanoma itself. ^{[1] [2]}

Common Non‑Cancer Reasons for High PSA

• Benign prostate enlargement (BPH) can raise PSA without cancer. ^[1]
• Prostatitis or urinary tract infection can transiently elevate PSA and often falls after treatment. ^[4]
• Age‑related changes and race/ethnicity differences influence normal PSA ranges; interpretation is individualized. ^[1]
• Recent ejaculation, bicycle riding, or prostate manipulation (DRE, biopsy, catheterization) can temporarily raise PSA. ^[5]

When to Be Concerned

• The higher the PSA, the higher the chance of a prostate problem, but it still may be non‑cancerous. ^[1]
• A persistently elevated or rapidly rising PSA over time deserves further evaluation, even though many cases are benign. ^[3]
• Clinical context matters: urinary symptoms (weak stream, frequent urination, burning), pelvic discomfort, fevers, or a history of prostate procedures can explain a rise. ^{[4] [5]}

Sensible Next Steps

• Repeat the PSA after a short interval (often several weeks to a few months) to confirm whether it remains high, ideally avoiding ejaculation and intense cycling for 48 hours and ensuring infections are treated before retesting. ^{[3] [4]}
• Discuss age‑based screening and your prior PSA trend with your clinician; decisions depend on your baseline PSA, overall health, and risk factors. ^[6]
• Consider adjunct tests if PSA stays elevated: free/total PSA ratio, prostate exam (DRE), prostate imaging, or targeted follow‑up, tailored to risk. Elevated PSA alone should not automatically lead to invasive procedures. [PM13] ^[3]

Special Notes for Those With Melanoma

• Melanoma care does not change PSA interpretation; PSA remains a prostate marker. ^[1]
• If you are on treatments or had recent procedures causing inflammation or infection, that could indirectly raise PSA by affecting the urinary/prostate tract, and should be considered in timing the test. ^[4]
• Prostate cancer and melanoma are unrelated; a high PSA does not mean melanoma progression. ^[1]

Bottom Line

• A high PSA in someone with melanoma is usually due to a prostate‑related cause, often benign, and not from melanoma itself. ^[1]
• Confirm with repeat testing and evaluate common reversible causes before worrying about cancer. ^{[3] [4]}
• Work with your clinician on a personalized plan based on PSA trend, age, symptoms, and overall health. ^[6]