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September 10, 2021

Does a High PSA Mean I Have Prostate Cancer?

Does a High PSA Mean I Have Prostate Cancer?

For many years, one of the primary screening tests for prostate cancer was a PSA test. If the number was high, further testing for prostate cancer was likely. Recently, however, doctors have found that an elevated PSA isn’t a sure sign of prostate cancer. While it could be an indicator of cancer, it can also be a sign of other non-cancerous prostate conditions.


What is a PSA Test?

Prostate-specific antigen, also known as PSA, is a protein produced in both healthy and cancerous cells in the prostate gland. The PSA test is used to measure the amount of this protein found in your blood. The level of the protein is measured in nanograms of PSA per milliliter of blood.

Originally, this test was approved to monitor prostate cancer in men who have already been diagnosed. It was later approved to be used in conjunction with a digital rectal exam in order to diagnose prostate cancer in people who are not showing other signs and symptoms.

According to the American Cancer Society, men without prostate cancer usually have a PSA under 4ng/mL of blood. But cancer can still be present even at a normal PSA range. Men with a PSA between 4 and 10 have a 1 in 4 chance that prostate cancer is present. And a PSA over 10 makes it about a 50/50 chance that he has prostate cancer.

With these numbers, it’s clear that an elevated PSA is not a sure sign of cancer.

Who Should Get a PSA Test?

Until recently, doctors were encouraging patients to get a PSA test done every year after the age of 50 or at the age of 40 or 45 if they are African American or have a brother or father who has been diagnosed with prostate cancer. However, after other researchers compared the risks and benefits of PSA screenings, many medical professionals stopped suggesting routine PSA tests. To date, it is suggested to talk to your doctor about when you should get a PSA test with consideration given to your age and medical history.

Reasons You May Have a High PSA Level

Many factors can influence your PSA level that could result in a higher number on the blood test. Some of the most common reasons for a high PSA include:

  • Natural aging: Even a healthy prostate can yield higher PSA levels as you get older.

  • Ejaculation: Recent ejaculation can make your PSA levels go up for a period of time. If you’re planning on having your PSA levels tested, your doctor will likely request that you don’t ejaculate for 24-48 hours before the test.

  • Enlarged prostate: A non-cancerous enlargement known as benign prostate hyperplasia (BPH) can raise PSA levels.

  • Prostatitis: An infection of the prostate gland that also increases PSA levels.

  • Riding a bike: Some studies indicate that riding a bicycle can put pressure on the prostate resulting in a short-term increase in PSA levels.

  • Hormones: Taking testosterone may also lead to a higher PSA level.

As you can see, several factors can influence your PSA levels. That is why it’s incredibly important that you let your doctor know about any medications, procedures, or lifestyle decisions that may influence PSA levels.

Reasons You May Have a Low PSA Level

On the other side of the spectrum, there are also reasons that you may have a low PSA level. Some of those factors include:

  • Certain medications: 5-alpha reduced inhibitors are a type of medication used to treat BPH or urinary symptoms. Long-term use of other medications such as aspirin or statins could also yield lower PSA levels. If you take this type of medication, make sure that your doctor knows before completing a PSA test.

  • Herbal mixtures: Certain supplements may also lower your PSA level. Let your doctor know about any dietary supplements that you take regularly.

You may be wondering why it’s a bad thing to lower your PSA level through one of the means above. The truth is, a lower PSA level could mean a lower risk of prostate cancer. However, it could also mask a cancer diagnosis. The most accurate PSA level is one that is not influenced by outside factors. This is why your doctor will ask for a thorough list of your medications and any other health information that may influence your result.

What’s Next if You Have an Elevated PSA?

First, don’t panic. In many cases, your doctor will ask you to wait a period of time and then take the test again to see if the elevated PSA was related to a lifestyle activity. They may also suggest some other tests before a prostate biopsy to rule out non-cancerous prostate conditions that may cause the higher PSA. A prostate biopsy is the best way to tell if cancer is present. But isn’t the next step for most people.

You should also talk to your doctor about any family history of prostate cancer to help with choosing the best next steps for you.

If you or someone you know has been recently diagnosed with prostate cancer, our team at Affiliated Oncologists is here to help. We provide quality education and resources so that patients just like you can make the most informed decisions about the best next steps. Request an appointment with one of our prostate cancer specialists.

Categories: Prostate Cancer