Understanding What Your PSA Level Means

One in eight men will be diagnosed with prostate cancer during their lifetime, so routine screening is important for early detection (finding cancer cells before they spread beyond the prostate gland). Early detection leads to more effective treatment and very high survival rates with prostate cancer. Depending on your racial background, family history, and other risk factors, if you are 40 or older, you should consider screening for prostate cancer and discuss a screening test with your doctor.

What is PSA?

PSA (prostate-specific antigen) is a protein produced by the prostate gland. Doctors use PSA levels to determine if there is a problem with the prostate, such as potential prostate cancer.  A group of researchers in New York in the early eighties was credited with developing the blood test to measure PSA levels. PSA tests have become common screening tests for prostate cancer. 

How is PSA used?

When you have a PSA test, a small amount of blood is drawn to measure your PSA level. A doctor uses your PSA level to determine next steps for identifying whether or not there is prostate cancer that should be immediately treated, which is known as  clinically significant cancer. Clinically significant prostate cancer  is different from low-grade prostate cancer, which often does not require treatment. Knowing that distinction can be very important for determining next steps and also having some peace of mind.

What does an elevated PSA level mean?

Your PSA level is only one piece of the puzzle in determining cancer risk. An elevated PSA level can result for many reasons other than prostate cancer, such as recent sexual activity, rigorous exercise, a prostate infection, or an enlarged prostate (which often occurs with age and is noncancerous). 

You have an elevated PSA level. Now what?

Traditionally, an elevated PSA test result meant that you had to then undergo a prostate biopsy. But research shows that more than 75% of patients with elevated PSA levels might not need a biopsy and can receive care based on their personalized risk level. Depending on your personal risk assessment factors and results, there are a variety of possible next options for additional testing. Determining any next medical step depends on your specific case and a consultation with your doctor.

While PSA levels are an important first step in determining prostate cancer risk, efforts to include more than PSA levels in cancer diagnosis show an evolution in the process of care for men and in identifying, evaluating, and responding to both high-risk and low-risk cancers. These efforts could result in earlier detection and more tailored treatment, and a decrease in false positives and side effects. 

Don’t be afraid of your PSA, as it’s an important indicator of what the next steps for your optimal health may be.