What Happens if Your PSA Numbers Are High?

The prostate-specific antigen (PSA) screening is a test conducted to measure the levels of PSA protein in the blood and check for signs of prostate cancer. According to The American Cancer Society, one in six American men are diagnosed with the prostate cancer every year, which is why regular screenings are encouraged. To promote early detection and proactive health, doctors recommend individuals get screened around the age of 50 or 45 if the person is at a higher risk for the cancer.

So, you get your results back from your PSA test—what happens if your PSA numbers are too high? Well, first, it’s important to understand what would be considered a high number. According to the experts, PSA levels of 4.0 ng/mL or lower are normal amongst healthy men. If it is higher, your doctor may recommend you take action. Before you start worrying, remember that high PSA levels do not always mean prostate cancer.

Common reasons why PSA levels may be high:

• Benign Prostatic Hyperplasia (BPH) – BPH is a condition where the prostate gland becomes enlarged, creating more cells, which increase PSA levels. Often, treatment is not necessary unless it negatively affects urination.
• Age – Even if you don’t have a history of prostate cancer, your PSA levels naturally increase as you age.
• Prostatitis – Prostatitis is common inflammation of the prostate, which can increase your PSA levels. However, in most cases, antibiotics can clear it up.
• Urinary Tract Infection – Any infection near the prostate gland can aggravate the prostate cells, causing your PSA levels to go up. If you have a urinary tract infection, wait until it clears up before having a PSA screening done.

While there are non-cancerous reasons for having elevated PSA numbers, it is important to take them seriously, nonetheless. Talk to your doctor about what this means for your health. Often, if the test results show high PSA levels, the doctor will usually order another PSA test to confirm the original finding. If the number is still high, other imaging tests—transrectal ultrasounds, cystoscopies, or x-rays—may be ordered. Many physicians also use alternates to PSA testing.

Common Alternatives to PSA Testing

• PSA Velocity – While PSA velocity is not a separate test, it is a way doctors can monitor the change of PSA levels over time. If your PSA number rises more than .75 ng/mL in a year, this might suggest cancer is present.
• PSA Density – Doctors may adjust PSA levels to how large a prostate is. Density is measured when the prostate is larger than average.
• Percentage of Free PSA – PSA moves in the blood in two major forms – bound to blood proteins or circulating freely. The percent-free PSA test monitors how much PSA is moving freely. Men with prostate cancer tend to have lower levels of free PSA.