The connection between elevated PSA and prostate cancer.
Elevated PSA and prostate cancer are not always synonymous. In other words, when a man has an elevated PSA, it doesn’t necessarily mean that he has prostate cancer. Prostate cancer is one of the most common cancers in men. In its early stages, men may not experience noticeable symptoms. In fact, cancer is often detected during a routine prostate screening. This initial screening includes a prostate specific antigen (PSA) blood test, and a digital rectal exam (DRE).
PSA (Prostate-specific antigen) blood test
Prostate-specific antigen is a protein produced by the prostate gland. When PSA levels are above the normal range, this may indicate an underlying medical condition including:
- Prostatitis – an inflammation/infection in the prostate (bacterial or non-bacterial).
- Benign prostatic hyperplasia (BPH) or enlarged prostate – a non-cancerous overgrowth of prostate tissue that restricts the flow of urine.
- Urinary Tract Infection
- Prostate Cancer
An elevated PSA may also result from non-medical factors. The provider will conduct further tests to precisely identify what is causing abnormal PSA levels.
Abnormal PSA levels
There is not an exact PSA number to determine when men definitely have prostate cancer. As a guideline, levels of 4 nanograms per milliliter (ng/mL) or above are cause for suspicion. However, a small percentage of men will have prostate cancer with blood levels below 4 nanograms. If PSA lab results show nanograms between 4 and 10, the of likelihood cancer increases. The probability of prostate cancer continues to escalate when PSA levels are over 10 nanograms per milliliter.
When PSA levels are high
When PSA results are abnormally high, the provider will conduct further testing to determine the cause. Based on their findings:
- Non-cancerous conditions can be treated.
- The PSA test may be repeated if outside factors (such as intercourse prior to testing) skewed the results.
- A prostate biopsy may be ordered if PSA levels are elevated, and the digital rectal exam is abnormal.
- The doctor will discuss treatment options if prostate cancer is confirmed.
It is recommended that men start prostate screening once they reach their 50s. For African American men, and those with a family history of prostate cancer, it is suggested that screening starts at 40.
If you would like to schedule an appointment for a prostate screening, or if you have elevated PSA levels, contact Urology Austin to schedule an appointment with one of our urologists.
Watch Dr. Ruff’s interview on KXAN TV. Dr. Ruff discusses prostate cancer, prostate cancer screening and Da Vinci robotic surgery.