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Does High Psa Always Mean Prostate Cancer

What Do The Numbers Mean

Does an elevated PSA always mean you have prostate cancer?

PSA levels are measured as a number of nanograms in each milliliter of fluid tested. This is written as ng/mL.

  • PSA level 2.5 ng/mL or lower: This is a normal PSA level for men under age 60, but in some cases, prostate cancer may still be present.
  • PSA level between 2.5 and 4 ng/mL: This is a normal PSA level for most men.
  • PSA level between 4 and 10 ng/mL: This indicates that prostate cancer might be present. At this level, there is about a 25% chance that you have prostate cancer.
  • PSA level 10 ng/mL or above: There is a 50 percent chance that prostate cancer is present. The higher the PSA rises above 10 ng/mL, the greater the chance that you have prostate cancer.

Your doctor may also monitor your PSA velocity, or doubling time, which means recording your baseline PSA the level at your very first PSA test and seeing how fast the PSA level increases over time. Rapid increases in PSA readings can suggest cancer. If your PSA is slightly high, you and your doctor may decide to keep an eye on your levels on a regular basis to look for any change in the PSA velocity.

What Does It Mean To Have An Elevated Psa

According to, a low PSA level is a sign of good prostate and overall health, while a high PSA level is a sign of risk of prostate cancer. As such, a low PSA level is ideal.

Among men who do not have prostate cancer, typical PSA levels under 4 ng/mL of blood, according to the American Cancer Society . As PSA levels rise, so does the risk for prostate cancer. For those with a PSA level over 10, the chance of having prostate cancer is more than 50 percent.

That being said, heightened levels do not always indicate that cancer is present. There is also no guarantee that PSA levels below 4 ng/mL means there is no prostate cancer.

In Men Over : Bph May Be The Cause Of High Psa

Benign prostatic hyperplasia is an enlargement of the prostate gland, but its not prostate cancer. “BPH means more cells, so that means more cells making PSA,” explains Dr. Castle.

BPH is the most common prostate problem in men over age 50. It may not need to be treated unless its causing frequent or difficult urination.

Your primary care doctor may be able to tell the difference between BPH and prostate cancer by doing a digital rectal exam, but commonly this will require evaluation by a urologist and further testing, such as a biopsy or imaging studies.

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Pros And Cons Of The Psa Test


  • it may reassure you if the test result is normal
  • it can find early signs of cancer, meaning you can get treated early
  • PSA testing may reduce your risk of dying if you do have cancer


  • it can miss cancer and provide false reassurance
  • it may lead to unnecessary worry and medical tests when there’s no cancer
  • it cannot tell the difference between slow-growing and fast-growing cancers
  • it may make you worry by finding a slow-growing cancer that may never cause any problems

Half Of Men Over 60 Have Prostate Cancer But Most Die Of Other Causes

David Samadi, MD

A new study looking at the prevalence of prostate cancer in men over 60 years of age found that just about 50 percent of men have the cancer. This statistic isnt as distrubing as it sounds most prostate cancers never develop into a harmful form of the disease and a large proportion of men will pass away from other causes without their prostate cancer progressing and becoming invasive.

The current study, published in the Journal of the National Cancer Institute, examined 320 men from Russia and Japan who had died at the age of 60 or older between 2010 and 2011. None of the men had been diagnosed with prostate cancer before their death. Men from Russia were used for the survey because they have similar fat intakes and sun exposures compared to North American men. Japanese men were examined because the incidence of prostate cancer is lower in the male population of Japan, most likely resulting in different diet compared to Caucasian North American men.

How often men should be tested for prostate cancer is a topic of debate among healthcare professionals. After all, the bottom line is that most American men will get prostate cancer if they live long enough. But many of them never experience any ill effects from the cancer, and typically die of natural causes having nothing to do with the prostate. And in fact, many doctors believe that prostate cancer is over-treated because not all men progress to a dangerous form of the disease.

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What Should I Expect If Im Told I Have Elevated Psa

If your provider finds an elevated PSA level, youll have repeat tests to check your prostate. Many men with elevated PSA levels even those who have prostate cancer live long, healthy lives. Prostate cancer may not need treatment, depending on how slowly the tumor is growing. Keep up with your regular appointments and tests so your care team can keep tabs on your health.

Is Psa Screening For Prostate Cancer Worthwhile

Cancer screeningprostateprostate cancerProstate cancer screeningcancer

Also asked, how effective is the PSA test for prostate cancer?

How reliable is the prostate-specific antigen test when it comes to detecting prostate cancer? In fact, studies have shown that about 70% to 80% of men with an elevated PSA who have a biopsy do not have cancer. However, many men undergo an ultrasound and prostate biopsy, to be certain.

Additionally, should I be screened for prostate cancer? Men should not be screened unless they have received this information. The discussion about screening should take place at: Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years. Age 45 for men at high risk of developing prostate cancer.

Beside this, what is the best screening for prostate cancer?

Two tests are commonly used to screen for prostate cancer: Digital rectal examination . A DRE is a test in which the doctor inserts a gloved, lubricated finger into a mans rectum and feels the surface of the prostate through the bowel wall for any irregularities. PSA blood test.

What should you not do before a PSA test?

You should avoid sexual activity before a PSA test because it may affect the test results.For the same reason, before having a PSA test men should not have:

  • exercised vigorously in the previous 48 hours.
  • an active urinary infection
  • had a prostate biopsy in the previous 6 weeks.

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What Is Considered A Dangerous Level Of Psa

There is no such thing as a dangerous PSA level. PSA, as described above, is a naturally occurring protein in men. A man is not harmed by high levels of PSA but high PSA levels may indicate there is an underlying health issue affecting the prostate gland.

Patients with a prostate gland may have a PSA level between 0 and 10,000. Therefore, it is important that a PSA result is interpreted by a doctor who will be able to examine your prostate and take a full medical history.

Try To Keep Up With Your Daily Routine

Does A High Psa Level Mean I Have Prostate Cancer?

If you work and are feeling up to it, try to go even if its not for the entire day. Talk to your boss, coworkers, or fellow volunteers about what you can handle. Remember that people who seem unsupportive might be worried about their own chances of getting cancer. Decide if youd rather avoid talking about cancer or be open about it. Do whatever feels right for you.

Spend time with family and friends or go on a trip. Ask yourself some simple questions: What makes me happy? What do I enjoy? Or do the things you havent had time for, such as going on a cruise, learning to play chess, or finding time to pick up that old guitar.

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My Psa Is Elevated What Could It Mean

First, realize that having an elevated PSA does not necessarily mean you have cancer in your prostate. Other causes for an elevated PSA include:

  • infection, instrumentation of the urinary tract, disruption, trauma, or manipulation of the prostate
  • certain conditions like prostatitis or enlarged prostate

You and your doctor will work together to identify any of these possible contributing factors to your higher PSA through measures like checking for urine infection, reviewing for history of instrumentation, inflammation and discussing family health history. You and your doctor may identify such a cause, address it with treatment, and re-test PSA to see whether the level has appropriately decreased.

If you and your doctor do not rule out any other causes, you will likely need to undergo another PSA test and a digital rectal exam. During this exam, a physician inserts a lubricated, gloved finger into the rectum to reach the prostate and feel for any lumps or hard areas. Continued abnormal results from the PSA test or rectal exam call for further investigation to identify clinically significant prostate cancer.

What Are Some Of The Limitations And Potential Harms Of The Psa Test For Prostate Cancer Screening

Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors that do not cause symptoms. Finding a small tumor, however, may not necessarily reduce a mans chance of dying from prostate cancer. Many tumors found through PSA testing grow so slowly that they are unlikely to threaten a mans life. Detecting tumors that are not life-threatening

that requires treatment.

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Risk Factors For Prostate Cancer

Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesn’t mean that you will get prostate cancer. It just means that your risk of the disease is greater.

  • Age. Men who are 50 or older have a higher risk of prostate cancer.
  • Race. African-American men have the highest risk of prostate cancerâthe disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
  • Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a man’s relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
  • Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.

What Is The Psa Test

Elevated PSA in Men

Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a mans blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter of blood.

The blood level of PSA is often elevated in men with prostate cancer, and the PSA test was originally approved by the US Food and Drug Administration in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the use of the PSA test in conjunction with a digital rectal exam to test asymptomatic men for prostate cancer. Men who report prostate symptoms often undergo PSA testing to help doctors determine the nature of the problem.

In addition to prostate cancer, a number of benign conditions can cause a mans PSA level to rise. The most frequent benign prostate conditions that cause an elevation in PSA level are prostatitis and benign prostatic hyperplasia . There is no evidence that prostatitis or BPH leads to prostate cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.

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What Are Psa Levels

Cells in the prostate gland produce PSA, and levels typically remain below 4 nanograms per milliliter .

Most individuals with prostate cancer have PSA levels above 4 ng/mL. However, some men with prostate cancer have a normal PSA level. Similarly, some men with a higher than average PSA do not have prostate cancer.

These variations mean that a PSA test alone cannot rule out or diagnose prostate cancer. However, the PSA test can identify whether a person has a higher risk of developing the disease.

Initial testing may include both a PSA test and a DRE.

During a DRE examination, a doctor inserts a finger into the rectum to check the prostate for anomalies.

If both of these tests suggest prostate cancer, then the doctor will arrange for a biopsy to confirm the diagnosis.

Prostate Cancer Screening: An Imperfect Test

Prostate cancer is the most common cancer in men other than nonmelanoma skin cancer, and the second-leading cause of cancer death in men, according to the American Cancer Society .

The only screening test available for it is the PSA test, a blood test that can reveal elevated levels of prostate specific antigen in the bloodstream. But PSA tests are imperfect. Several factors can contribute to elevated levels.

PSA screening for all men has been criticized because it can lead to false positive results, unnecessary medical tests, and patient anxiety.

Moreover, the test sometimes reveals the presence of nonaggressive cancer that is unlikely to require treatment or cause problems if left alone. Some men are overtreated for it and suffer unnecessarily from some of the long-term complications of treatment, such as urinary incontinence and erectile dysfunction.

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Screening Tests For Prostate Cancer

Screening is testing to find cancer in people before they have symptoms. Its not clear, however, if the benefits of prostate cancer screening outweigh the risks for most men. Still, after discussing the pros and cons of screening with their doctors, some men might reasonably choose to be screened.

The screening tests discussed here are used to look for possible signs of prostate cancer. But these tests cant tell for sure if you have cancer. If the result of one of these tests is abnormal, you will probably need a prostate biopsy to know for sure if you have cancer.

Are Psa Tests Regularly Done

High PSA & Prostatitis | Ask a Prostate Expert, Mark Scholz, MD

The UK government has not introduced a prostate cancer screening programme and therefore, no men are currently called in to have their PSA levels measured. Patients with new urinary symptoms like decreased urinary flow, for example, may be advised to have a PSA test once the implications of the test have been discussed. Unfortunately, the PSA test is not always accurate and can lead to further investigations in some men who do not actually have prostate cancer .

Some men, who have no urinary symptoms, may want to undergo a PSA test. This can be because they have become anxious about the possibility that they have prostate cancer and want to get checked out. A PSA test can be performed provided that the patient has had a proper discussion about the pros and cons of the test. NHS England has produced a guidance leaflet for men aged over 50 who are considering a test and have no urinary symptoms.

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What Is Considered An Elevated Prostate

Researchers havent settled on a single normal PSA level. Previously, a level of 4.0 ng/mL or higher would lead to more testing, usually a prostate biopsy. During the biopsy, a healthcare provider removes a small sample of prostate tissue to check it for cancer.

However, healthcare providers now consider other issues together with the PSA level to decide whether to perform a biopsy. Your age, general health, family history and health history factor into the decision.

The Risks And Benefits Of Psa Screening For Prostate Cancer

The study looked at trends in prostate cancer incidence in men 50 and older from 2005 through 2016. It found that for all races and ethnicities combined, local-stage disease decreased by 6.4 percent per year from 2007 through 2016 in men 50 to 74, and by 10.7 percent per year from 2007 through 2013 in men 75 and older.

For advanced stage prostate cancer , the incidence increased in both age groups.

Among men ages 50 to 74, cases of advanced disease increased 2.4 percent per year from 2008 to 2012 and by 5.6 percent per year from 2012 to 2016. Among men ages 75 and older, advanced prostate cancer cases increased 5.2 percent per year from 2010 to 2016.

That is a rapid increase, Dr. Jemal said. Five percent per year is a lot.

The new statistics are largely a result of the 2012 screening recommendations. Its not clear yet what impact the 2018 USPSTF recommendations will have on PSA screening.

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