Have you had or are you about to have a PSA blood test? If so, your doctor will tell you the level of PSA (protein specific antigens) in your blood, with a number from less than one all the way up to maybe 20. If your PSA level is below 4 (ng/ml), it’s unlikely that you have prostate cancer. However, if your PSA level is between 4 and 10, it is possible that you do have prostate cancer, as the risk factor is about 25%. What if your PSA level is higher than 10? Then the risk that you have prostate cancer jumps to 67%.

What Is PSA?

Protein specific antigens (PSA) are a protein produced by your prostate gland. They can be produced by both cancerous and non-cancerous prostate tissue. It’s normal for a small amount of the PSA to get into your blood stream. However, cancer cells usually produce more PSA than benign (non-cancerous) cells. In turn, this can cause the PSA levels in your blood to rise – an indicator that you may have prostate cancer.

What Does A High PSA Level Mean?

It can be scary if your doctor tells you that you have a PSA level that’s higher than 4. But this doesn’t necessarily mean that you have prostate cancer.

The problem with the PSA blood test is that it’s not always accurate indication of prostate cancer. Many men have been tested and received what’s known as a false positive. In other words, their PSA level was higher than 4 - or even above 10 – but they did not have prostate cancer. Unfortunately, the opposite is also true. Some men have been tested false negative. This means their PSA levels were lower than four but they did have prostate cancer.

What May Cause A High PSA Level

In addition to prostate cancer, there are other conditions that can cause you to have a high PSA level. One of the most common of these is benign prostatic hyperplasia or BPH. The symptoms of BPH include:

  • Trouble starting to urinate
  • Stopping and starting frequently when urinating
  • Having to strain to urinate
  • Having to urinate frequently
  • Feeling sudden, strong urges to urinate
  • Feeling that your bladder is not empty even though you just urinated

While BPH is not a life-threatening disease, it is a progressive disease that can rarely lead to other problems such as kidney or bladder damage.

The second reason you might have an elevated PSA level is prostatitis. There are three different types of prostatitis that can affect you. They are acute bacterial prostatitis, chronic bacterial prostatitis and chronic nonbacterial prostatitis.

Acute bacterial prostatitis is a sudden bacterial infection, marked by an inflammation of the prostate. This infection requires fast treatment, as it can lead to bladder infections, abscesses in the prostate or even a completely blocked urine flow.

Chronic bacterial prostatitis is the result of recurrent urinary tract infections that have entered the prostate gland. Its symptoms are similar to acute bacterial prostatitis but usually less severe. This form of prostatitis is difficult to diagnose and usually treated with antibiotics for four to 12 weeks.

The most common form of prostatitis is chronic nonbacterial prostatitis/chronic pelvic pain syndrome. It accounts for about 90% of all prostatitis disease. Its symptoms are urinary and genital pain for at least the past six months.

If You Have A High PSA Level

As you have read, a high PSA level by itself does not indicate that you have prostate cancer. In fact, your doctor will more than likely perform a DRE or digital rectal examination in conjunction with the PSA blood test. In this test, he or she inserts a finger in your rectum and actually feels the prostate. If it is not inflamed or doesn’t have any lumps, the odds are that you don’t have prostate cancer, despite the fact that you have a high PSA.

Other Tests Your Doctor Might Order

If the test reveals that you have a PSA level higher than 4, your doctor may order additional tests, especially if the PSA level is above 10. This could be a urine test to see if your have a urinary tract infection (UTI) or blood in your urine. Or it could be a transrectal ultrasound, an x-ray, a cystoscopy or even a biopsy.

In many cases, the cause of the high PSA level will be something benign such as the prostatitis or BPH. However, even if it turns out that you do have prostate cancer, the good news is that the chances are, it’s been detected early and can be successfully treated before it can metastasize and spread to your other organs.

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