Are you a man between the ages of 50 and 75? If so, you doctor is probably counseling you to have an annual PSA blood test. In some cases, you may be told you have an elevated PSA level.

What Is An Elevated PSA Level?

A normal PSA level for a man over the age of 50 is considered to be 4 (ng/ml) or less. This is the level that has traditionally been used as a sort of cutoff point for concern about the risk of prostate cancer. For that matter, it is not unusual to have a PSA of less than one – such as 0.80.

If you have a PSA of more than 4, your doctor may say that you have an elevated PSA level. This will be especially true if your PSA level is greater than 10.

What Does An Elevated PSA Level Mean?

While a high PSA level can be an indicator of prostate cancer, it’s important to understand that there can be other reasons as to why you have an elevated PSA level. In fact, there have been many cases where men had a high PSA level but no prostate cancer. This is called a false positive. The danger of a false positive is that it can lead to unnecessary treatments such as a biopsy.

Unfortunately, the opposite is also true. There have been cases where men with a low PSA level did have prostate cancer.

If you have been told that you have an elevated PSA level, keep in mind that there is no specific “normal” PSA level. In fact, it is common for PSA levels to vary somewhat from lab to lab. This means that one elevated PSA test does not mean you need to have a biopsy. However, the higher the PSA, the more likely it is that you have prostate cancer.

Having A PSA Blood Test

The PSA test is a blood test. The doctor or phlebotomist will draw blood – probably from the inside of your elbow or the back of your hand – and then send the blood to a laboratory.

What the lab will test for is the level of PSA or protein specific antigen in your blood. This is a protein produced by prostate tissue. It is normal for some of this protein to get into your blood steam – which is why you might have a PSA level of 4 or even less. However, both prostate cancer and some other benign (non-cancerous) tissue will produce more of the protein specific antigen than normal prostate cells, resulting in an elevated PSA level.

What Happens If You Have An Elevated PSA Level?

Most doctors will also do a digital rectal exam (DRE) in conjunction with the PSA blood test. In this procedure, the doctor inserts his or her finger in your rectum and feels the prostate gland. If you have an elevated PSA - but the prostate is not inflamed, is not tender and has no lumps - you will most likely be told not to worry and to come back in a year. This is called “watchful waiting”.

Beyond this, there are other tests you doctor may order such as:

  • X-rays
  • Transrectal ultrasound
  • Urinalysis
  • Cystoscopy
  • Biopsy

An Elevated PSA Level Does Not Mean You Have Prostate Cancer

There are two other benign (non-cancerous) reasons why you might have an elevated PSA level. The first of these is a condition called prostatitis. There are actually three kinds of prostatitis: acute bacterial prostatitis, chronic bacterial prostatitis and chronic non-bacterial prostatitis. All three of these diseases show about the same symptoms:

  • Difficulty urinating
  • Pain or burning during urination
  • Frequent urge to urinate
  • Chills and fever

The other major, non-cancerous cause of an elevated PSA is a condition called benign prostatic hyperplasia (BPH). This is a fancy way of saying the prostate has become enlarged and this condition is very common in men over the age of 50. The symptoms of BPH are:

  • Feeling that the bladder is not empty after urinating
  • Having to urinate frequently, particularly throughout the night
  • Trouble starting to urinate
  • Having to strain to urinate
  • Feeling sudden urges to urinate

If you do have an elevated PSA level, there is still good news. As you have read, it is not an infallible test. In fact, the use of PSA testing has become very controversial over the past three to five years. There are arguments on both sides – pro and con – regarding its efficacy. Plus, your elevated PSA may well have been caused by one of the benign conditions described above. In other words, an elevated PSA can be cause for concern but doesn’t definitely mean that you have prostate cancer.

Next >> Benign Prostatic Hyperplasia