The PSA, or prostate-specific antigen test, is the first screening test to detect prostate cancer, the most common cancer in men. There are a number of reasons your PSA can be high, and it’s not always necessarily due to cancer. We’ll help you discover what you need to know about a high PSA.
Not all tests are infallible, and that includes the PSA, which is the best screening tool to detect cancer in men. If that seems confusing, you’re not alone.
A man’s prostate is a small gland that sits below the bladder, and its purpose is to create semen. PSA is the protein produced in the prostate gland whether you have cancerous OR non-cancerous tissue. If the PSA level of protein is high, it may indicate cancerous tissue, but it can also mean you have an infection or BPH.
Benign prostatic hyperplasia or BPH is non-cancerous and simply means an enlarged prostate. To make things even more confusing, most men develop BPH as they age, and in addition, PSA levels rise as men age.
Sometimes men with normal PSA levels actually have cancer and others with high levels do not. In addition, a man with a high level can have slow-growing cancer that is asymptomatic and will not be a problem.
Since we know a high PSA level does not necessarily mean cancer, there are a series of next steps your do will take once a PSA test comes back high.
A DRE or digital rectal exam is normally performed in conjunction with the PSA. Here your physician can determine any abnormalities or lumps on the prostate.
If that is inconclusive, the next step may be an MRI which is quite effective in finding cancer, BPH, or an infection as the cause of the elevated PSA.
If the MRI is still inconclusive, the next step would be a prostate biopsy. During a prostate biopsy, a needle is inserted into the prostate gland to collect tissue samples. Ultrasound is utilized with a prostate biopsy so the physician knows exactly where to place the needle. It’s possible this may need to occur 6 to 12 times to get samples from different parts of the prostate.
Physicians also watch the velocity of PSA tests and how quickly levels rise over time. They rarely will look at only one test.
Prostate cancer surgery has multiple side effects and is only performed when absolutely necessary in consultation with Denver BPH.
Summary Of What You Need To Know
The following takeaways list what you need to know about a high PSA:
- A high PSA does not mean you have cancer.
- A normal PSA does not always indicate non-cancerous tissue.
- With a normal PSA level, you can still have slow-growing cancer with no symptoms.
- The PSA test is still the best first tool used by your doctor, but a high reading is used in conjunction with a DRE, an MRI, and a biopsy with ultrasound to conclusively determine a cancerous tumor.
- The velocity of PSA growth is an important component before surgery is recommended.
- New tests are being developed to better detect prostate cancer without unnecessary red flags and false positives.
Contact to schedule a PSA test or for questions about your own PSA level test.