What is PSA?
PSA is a protein (called prostate specific antigen) produced by cells that line the small glands inside the prostate. When a man has prostate cancer, his PSA levels tend to increase which is why a PSA test is often used by physicians to screen for prostate cancer.
What is a PSA Test?
To conduct a PSA test, a physician will take a blood sample and send it to a laboratory for analysis. A PSA test result is an important factor when determining prostate cancer diagnosis, plan, and treatment. However, an elevated PSA does not always mean a man has prostate cancer. Additionally, a low PSA does not mean that cancer is not present.
When should I start PSA Screenings?
Doctors often recommend PSA testing in men 55 and older. However, your doctor may recommend testing your levels at an earlier age if you have known risk factors for prostate cancer, including family history of the disease or the know presence of a germline mutation.
Understanding your PSA results
In general, doctors often consider PSA levels of 3.9 ng/mL and lower to be normal depending on your age. It is also important for your doctor to track any increases in your PSA levels as these increases may suggest the presence of cancer even if your PSA is in the normal range.
According to American Cancer Society, men with a PSA level between 4.0 and 10.0 ng/mL have a 25% chance of having prostate cancer. Men with a PSA level greater than 10.0 ng/mL, their chance of prostate cancer is over 50%1
Consult with your physician regarding PSA results and PSA ranges.
As mentioned above a high PSA doesn’t always mean a man has prostate cancer. PSA levels can be elevated because of several benign conditions.
What are other reasons why PSA levels may have risen?
It is normal for PSA levels to increase gradually with age.
Men Over 50: BPH
Benign prostatic hyperplasia (BPH) is an enlargement of the prostate gland, but it is not prostate cancer. BPH is another common prostate problem in men over age 501. It may not need to be treated unless it causes frequent, difficult urination or other urinary symptoms. Your primary care doctor may be able to tell the difference between BPH and prostate cancer by doing a digital rectal exam (DRE), but commonly this will require evaluation by a urologist and further testing, such as a biopsy or imaging studies.2
Prostatitis: A Common Problem in Men Under 50
Prostatitis is the most common prostate problem for men younger than 50.2 Prostatitis caused by bacteria is treated with antibiotics. Another, more common type of prostatitis, called nonbacterial prostatitis, can be harder to treat and may last a long time.2
Any of the following medical procedures could potentially lead to a rise in PSA:
- Prostate Biopsy
- Transurethral Resection of the Prostate (TURP)
- Urethral Catheter
- Or any other procedure that involves the prostate. If you have had any of the above medical procedures or conditions, you should consult your physician to see if you should wait before having your PSA test.
A Digital Rectal Exam (DRE)
To avoid this type of elevation, doctors will usually draw blood for a person’s PSA level prior to conducting a rectal exam.
Urinary Tract Infection
If you have been diagnosed with a urinary tract infection, this could irritate or inflame the prostate cells that could lead to a result of a falsely elevated PSA. Be sure to wait until after the infection has cleared up before getting a PSA test. In men, most urinary tract infections are caused by bacteria and respond well to antibiotics.
Participating in a sexual activity that involved ejaculation within about 48 hours before testing can affect PSA results.
Certain Medications and Supplements
Medications such as aspirin, statins, nonsteroidal anti-inflammatory drugs, or medication for urinary problems have the potential to affect PSA levels. Sport or nutritional supplements such as testosterone can cause PSA levels to rise.
Riding a Bicycle
There have been studies that suggest cycling may raise PSA. The studies mention the rise may be due to the seat putting pressure on the prostate. It should be noted that not all studies have found this to be true.
Having a high PSA result when paired with other screening tests, including DRE, can be an indication you may be at risk for prostate cancer, which can result in your doctor recommending a biopsy to confirm a prostate cancer diagnosis.