September 10, 2021
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 the result. However, in recent years doctors found that an elevated PSA isn’t a sure sign of prostate cancer. It could be an indicator of cancer, but it can also be a sign of several common, 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 combination with a digital rectal exam to screen for 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.
Non-Cancer-Related Reasons You May Have a High PSA Level
Prostate conditions are rather common in men, especially as they age. They aren’t a sign of cancer but should be addressed if you’re experiencing bothersome symptoms such as low urine flow, blood in the urine or semen, or pain. Some of the most common reasons for an elevated PSA include:
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. This can be treated with antibiotics.
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.
Natural aging: Even a healthy prostate can produce 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.
If you take hormone therapy or ride a bike regularly, it’s also important that you let your doctor know so they can consider that when reviewing your test results.
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.
PSA and its Role in Prostate Cancer Staging
PSA levels in men who were already diagnosed with the disease are used to determine the stage of prostate cancer.
Your doctor will review your recent PSA tests along with your biopsy results and images of your prostate to determine how much prostate cancer is present and how far it’s progressed. They will also determine your risk group based on this information.
Risk groups guide the prostate cancer doctor when recommending a treatment plan based on the likelihood of cancer growing quickly and even spreading beyond the prostate.
Prostate Cancer Doctors Available in the South Chicago Suburbs
If you or someone you love was diagnosed with prostate cancer, our team at Affiliated Oncologists is here to help. It’s a good idea to talk with an oncologist in addition to your urologist after a prostate cancer diagnosis to determine if treatments are necessary yet, and if so, which order would be ideal.
We want you to make the most informed decision about the best next steps for you. Request an appointment with one of our prostate cancer doctors located in the south Chicago suburbs including Chicago Ridge, Mokena, Hazel Crest, Palos Heights, Orland Park and Oak Lawn, IL.
Originally published September 2021. Updated February 2025.
Categories: Prostate Cancer