An elevated prostate-specific antigen (PSA) has been a strong indicator of the presence of prostate cancer. However recently, it has become more commonplace for physicians to suggest a repeat PSA test instead of immediately opting to perform a prostate biopsy.
The American Urological Association (AUA) is strongly advising physicians to perform a second PSA test to see if the levels again range from 4 and 10 ng/mL and to observe if they are rising. This is especially advisable in men who have never had prostate cancer and do not have a family history of the disease.
A prostate biopsy has never been a full proof way to detect cancer. During a prostate biopsy, numerous core samples are obtained from various areas of the prostate and in some instances the biopsies come back negative for the presence of a malignancy, but the PSA levels continue to rise on repeat testing and a follow-up biopsy may frequently finally detect a malignancy. This is why many physicians are opting to monitor the PSA levels with a second follow test instead of immediately turning to a prostate biopsy.
According to the European Association of Urology, a man with a rising PSA with a velocity of 1 ng/ml/yr, is highly suspicious of having prostate cancer. Such a rising PSA is easily detectable utilizing a second PSA instead of an immediate biopsy.
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