Archive for March, 2009

Understanding PSA – I_D_2_b_2

Understanding PSA

Knowing your previous PSA levels is helpful, but not necessary. Nonetheless, your PSA level is mildly elevated. Follow-up is needed. Keep in mind that your risk of prostate cancer is still less than 40 percent.

Your options include

  • referral to a urologist (prostate specialist)
  • repeat PSA testing in several months
  • measuring your “free” PSA level — This special way of testing your PSA level may help to decide if a biopsy is needed. High levels of free PSA are reassuring, while low levels are worrisome for cancer.

Understanding PSA – I_D_2_b

Understanding PSA

The next thing to determine is how fast your PSA levels has been rising. You can figure this out if your PSA was checked within the past year or so. You should subtract your last PSA result from your current results. For example, if your PSA was 4.5 last year and is 5.0 this year, it has increased by 0.5 points (ng/ml) over the past year. A quickly rising PSA is worrisome, while a slowly rising PSA (or PSA level that goes down) is reassuring.


Has your PSA level been checked within the past year?

    Understanding PSA – I_D_2_a

    Understanding PSA

    Ejaculation or vigorous bicycle riding can cause a small increase in your PSA level. Consider repeating your PSA test in two weeks, after you’ve avoided bicycle riding and intercourse for at least 48 hours. If your repeat PSA level returns to normal (less than four), this is excellent news. If your PSA test remains elevated, further evaluation is probably needed. Your options include:

    • referral to a urologist (prostate specialist)

    Understanding PSA – I_D_2

    Understanding PSA

    PSA levels can also go up for other reasons. For example, riding a bicycle can put pressure on the prostate and cause a temporary spike in your PSA level. The same is true for ejaculation during sex or masturbation. In general, these activities cause PSA levels to rise only a little, and the PSA should return to normal within several days.


    Did you ride a bicycle, have sexual intercourse or ejaculate in the 48 hours before blood was drawn for your PSA test?

    Understanding PSA – I_D_1

    Understanding PSA

    Your PSA level may be falsely elevated. This means that although your PSA level is above normal, there is a good chance that you do not have prostate cancer.

    Contact your doctor. You may need antibiotic treatment if you have evidence of a urinary tract infection or prostatitis. You should also talk to your doctor about repeating your PSA test in 1-2 months. If your repeat PSA level returns to normal (less than four), this is excellent news. If your PSA test remains elevated, further evaluation is probably needed. Your options include

      Understanding PSA – I_D

      Understanding PSA

      Your PSA level is moderately elevated. About one in three men with a moderately elevated PSA level will be found to have early stage prostate cancer if a biopsy is performed. Early stage prostate cancer rarely causes symptoms, and your prostate may feel totally normal when examined by your doctor (digital rectal exam). One piece of good news is that early stage prostate cancer can often be cured.

      Understanding PSA – I_E_2

      Understanding PSA

      Contact your doctor. Your PSA level is high. Your risk of prostate cancer is greater than 50 percent. Immediate follow-up is warranted. Speak to your doctor about referral to a urologist (prostate specialist) or arranging for a prostate biopsy.


      You have reached the end of this guide. What would you like to do?

      Understanding PSA – I_E

      Understanding PSA

      Your PSA level is moderately elevated. More than half of men whose PSA level is ten or above will be found to have prostate cancer if a biopsy is performed.

      However, not all men with an elevated PSA level have prostate cancer. Instead, the PSA level can rise for another reason, such as

      • benign growth of the prostate gland (also known as BPH or benign prostate hypertrophy)
      • a prostate infection or urinary tract infection
      • damage to the prostate caused by a surgery or trauma.

      Understanding PSA – I_C

      Understanding PSA

      Your PSA level is below 4.0 ng/ml. This is generally a reassuring result, and your risk of having prostate cancer is low.

      However, your PSA level is slightly higher than expected for someone less than age 50. Speak with your doctor about the following options

      • referral to a urologist (prostate specialist)
      • repeat testing in 3-6 months to make sure that your PSA level is not rising

      Understanding PSA – I_B

      Understanding PSA

      Your PSA level is in the normal range. This is a reassuring result. You have a low risk of being diagnosed with prostate cancer within the next few years.

      Consider having your test repeated in one to two years.


      You have reached the end of this guide. What would you like to do?