Ihave recently been diagnosed with polymalgia rheumatica (PMR)and
Rheumatic Arthritis.  At the same time my PSA (Prostate Specific
Antigen) reading has been increasing fairly rapidly.  Somewhere I
think I read that there may be a connection between the two conditions
- ie the former causing the latter.  My Google search has not been
able to confirm this.

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Request for Question Clarification by synarchy-ga on 21 Sep 2002 16:19 PDT

Hi - I was not able to find resources on the web to completely answer
your question.  I did find an abstract for a paper suggesting the PSA
levels may be unreliable in individuals with rheumatological
disorders.  I also found numerous articles suggesting that
rheumatological symptoms may result from cancers, but I could not find
any specific references to prostate cancer.  Perhaps this information
will assist you, or another researcher, in finding the specific answer
that you requested.

It appears that the cause and effect relationship between
rheumatologic disorders and an elevated PSA could go either direction.
 Inflammatory conditions (such as rheumatoid arthritis) can cause
elevations in "tumor markers" (ie PSA for prostate cancer, CA125, aFP,
CEA, etc).  In fact, according to the study below, PSA is of low
predictive value for diagnosing a cancer in patients with
rheumatological disorders.
A medical analysis of this subject (abstract only):
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11675572&dopt=Abstract


Elevations of PSA are not as reported as elevations of other tumor
markers - as PSA is only present in the prostate gland (which isn't
involved in PMR or RA), I would be concerned that the causal
relationship is going the other direction and that an underlying
prostate cancer could be causing the rheumatological symptoms.  It
appears that cancers can cause rheumatologic conditions that are
mostly indistinguishable from non-cancer related rheumatologic
conditions.  I was not able, however, to find a reference for prostate
cancer causing rheumatological symptoms.


A nice paper (directed at doctors, but should be mostly approachable)
- doesn't mention prostate cancer specifically:
http://www.postgradmed.com/issues/2002/04_02/marmur3.htm

Another good paper on the subject, which, also, unfortunately, doesn't
mention prostate cancer:
http://www.moffitt.usf.edu/pubs/ccj/v4n3/article5.html

A recent summary published last year in the journal "Current Opinion
in Rheumatology" also discusses the association between rheumatologic
disorders and malignancies:
http://www.co-rheumatology.com/article.asp?ISSN=1040-8711&VOL=13&ISS=1&PAGE=62

There is a paper, a meta-analysis of available medical literature,
which suggests that rheumatic diseases may be a manifestation of an
underlying cancer:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10468414&dopt=Abstract

Another paper discussing this connection:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11054684&dopt=Abstract

Hello -

I've done some more digging and have found the following article (in
addition to those listed above).

This article describes a case study of joint pain in an elderly
patient and notes that arthritis of malignancy may be associated with
an elevated PSA level (third page, middle column, paragraph above
"treatment").
http://www.aaos.org/wordhtml/archives/arch9.pdf

It appears that most of the evidence linking the two observations
would suggest the possibility of an arthritic syndrome being caused by
an underlying malignancy of the prostate.  There is the one article,
which I mentioned above, which suggests that PSA levels can be
unreliable in patients with rheumatic diseases.

Please let me know if you need further information.