PSA test results

This test measures the level of PSA (prostate specific antigen) in your blood. It can be used to help diagnose prostate problems, including prostate cancer.

Why do you have a PSA test ?

PSA is a protein made by your prostate gland. It is measured in nanograms per millilitre of blood (ng/ml). PSA levels can range from less than 1ng/ml up to 100 ng/ml and beyond.

The PSA test measures the level of PSA (prostate specific antigen) in your blood. It can be used: 

  • To help diagnose prostate cancer. 
  • To help diagnose other prostate problems.
  • To show how your cancer is responding to treatment − PSA usually falls once you start treatment.

What are normal PSA levels?

There is no such thing as a completely 'normal' PSA level. For example, PSA levels often rise as you get older. There are also other things that can affect your PSA level. But to see if there might be a problem with your prostate, doctors will check your PSA level against what is usual for your age:

  • Under 50 years of age: Up to 2ng/ml
  • 50-59: Up to 3ng/ml
  • 60-69: Up to 4ng/ml
  • 70+: Up to 5 ng/ml

Does a high PSA mean I have cancer?

No. There are other reasons your PSA can be raised. A PSA test alone can’t diagnose cancer, but your GP will use the age-range levels to decide if you might need further tests.

What are some of the reasons PSA can be raised?

  • Recent urinary tract infection
  • Prostatitis (infection in the prostate)
  • An enlarged prostate, which is common as you get older
  • Prostate cancer
Other things that can affect PSA levels:
  • A recent operation on your prostate gland.
  • A recent prostate biopsy.
  • Ejaculation within the previous 48 hours.
  • Tests on your bladder or prostate gland, especially a tube (catheter) placed there.

Some medications can such as finasteride (Proscar ®) and dutasteride (Avodart ®), which are taken for an enlarged prostate, can make the PSA appear lower than it is. If you have started taking one of these medications, talk to your GP/consultant. They will adjust your PSA reading and discuss the normal range for you.

What will happen if my PSA is raised?

  • If your PSA is a little raised and you have no other abnormal results, such as from a digital rectal examination, your GP will usually advise you to have your PSA done again after about 6 - 12 weeks.
  • If your PSA is raised a second time or it’s a little raised but your prostate gland feels abnormal, your GP will usually advise you to see a urologist for further tests, such as an MRI of your prostate and a prostate biopsy.
  • If your PSA is very high (such as over 100), usually your GP will refer you to a urologist straight away.

PSA density

If you have a raised PSA and your prostate is enlarged, the urologist you are referred to may work out your prostate density to decide if you need further tests and a prostate biopsy. Prostate density is worked out by dividing the PSA reading by your prostate volume (the estimated size of your prostate). The size of your prostate is worked out using an MRI scan or a trans-rectal ultrasound (TRUS).

What happens if my PSA is in the normal range?

  • If your PSA is normal and your prostate gland feels normal, your GP will tell you if and when you need to think about having your PSA test repeated. 
  • If your PSA is normal but your prostate gland feels abnormal, your GP will refer you to a urologist.
  • If you have a normal PSA but you’re troubled by urinary symptoms, you may still be referred to a urologist to help improve your symptoms.

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