What Does a High PSA Level Test Result Mean?

What does high PSA test mean?
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Question: What Does a High PSA Level Mean?

I went to the doctor for my regular checkup and in general everything looked good. I think I am pretty healthy for a man of my age and I don't have any symptoms of prostate problems. But when my laboratory results came back, it showed that my PSA test result was high. What does it mean? Does it mean I have cancer? What else could cause a high PSA level?

What High PSA Test Results Can Mean

The PSA test is a blood test used to measure a substance called prostate-specific antigen in the blood.

It is used as a screening tool for prostate cancer.

In a healthy male, the PSA level should be less than 4 nanograms per milliliter of blood. Anything higher than 4 can indicate an increased risk that prostate cancer is present. This increased risk is about 25% for levels between 4.0 ng/ml and 10.0 ng/ml.

This means is your PSA level is 5.1, you may have as much as a one in four chance that it is due to a tumor in your prostate gland. But you have three out of four chances that it is high due to something else. This makes the 4-10 ng/ml the gray zone.

A higher PSA level about 10.0 ng/ml shows a 50% chance that you are at risk of having prostate cancer, according to the American Cancer Society.

But because the PSA test often has higher levels when cancer isn't present, its use as a screening tool is limited and medical opinion about how often it should be done is changing. Your doctor will decide based on your age and other factors what the next step should be if you have a high PSA level.

High PSA Levels Don't Always Mean Prostate Cancer is Present

Keep in mind that PSA tests are notorious for producing false positives - being high when there is no cancer present. Other tests such as a biopsy or digital rectal exam may be performed to further evaluate your prostate for cancer.

Factors that can elevate the PSA levels:

  • Ejaculation: The test instructions should tell you to not have an ejaculation for at least 24 hours before the blood test, and 48 hours may be a more cautious window. If you have had an ejaculation, it may be wise to ask for the test to be postponed until you can have your blood drawn at an appropriate time.
  • Blood drawn after digital rectal exam: This can raise the PSA level temporarily, so it is important to have your blood drawn before you see the doctor, not afterward.
  • PSA levels can naturally increase with age
  • inflammation of the prostate gland can cause high PSA levels.
  • non cancerous enlargement of the prostate can raise PSA.

High PSA Levels After Cancer Treatment

After treatment for prostate cancer, the PSA level will usually drop and even become undetectable. Your doctor will continue to monitor your PSA level. If it begins to rise, a recurrence of the cancer is suspected.

Sources

Prostate-Specific Antigen (PSA) Test, National Cancer Institute, July 24, 2012

PSA, Lab Tests Online, American Association for Clinical Chemistry, December 16, 2015.

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