What is Elevated PSA?
PSA is a protein produced by the prostate that helps keep semen liquid outside the body. When the prostate is healthy, a very small amount of PSA escapes from the prostate and enters the bloodstream. When the prostate is unhealthy-if it is inflamed, enlarged or contains cancerous cells-larger amounts of PSA leak into the bloodstream.
Prostate Cancer screening includes a test to measure the levels of prostate-specific antigen (PSA) in your blood. Elevated PSA levels are often an early indication of prostate cancer as well as other prostate disorders. Results from regular PSA screenings will show whether your PSA levels have changed year to year and whether that change is cause for concern.
Most men without prostate cancer have PSA levels under 4 nanograms per milliliter (ng/mL) of blood. The chance of having prostate cancer goes up as the PSA level goes up. When prostate cancer develops, the PSA level usually goes above 4. Still, a level below 4 does not guarantee that a man doesn’t have cancer. Here are some statistics:
- About 15% of men with a PSA below 4 will have prostate cancer on a biopsy.
- Men with a PSA level between 4 and 10 have about a 1 in 4 chance of having prostate cancer.
- If the PSA is more than 10, the chance of having prostate cancer is over 50%.
What causes Elevated PSA?
PSA elevation may be due to many different prostate changes, such as benign (non-cancerous) enlargement, inflammation or infection. Prostate cancer may also cause an elevation in the PSA level.
If you have Elevated PSA, schedule an evaluation with Dr. Steinberg in his Milford office at (508) 473-6333.
How is Elevated PSA diagnosed?
A simple blood test is used to measure a man’s PSA level.
Can I lower my PSA?
While age and genetics are major factors affecting PSA levels, there are many lifestyle factors that may play a role in PSA levels.
Learn more about ways you may be able to lower your PSA here.
What's next if I have Elevated PSA?
Dr. Steinberg is an expert at evaluating and monitoring patients who have Elevated PSA levels for prostate cancer. A physical exam, evaluation, and diagnostic testing are used to determine a patient’s risk of having or developing prostate cancer.
Medical History and Physical Exam - During an initial office visit, Dr. Steinberg will perform a Digital Rectal Exam (DRE), inserting a gloved, lubricated finger into your rectum to examine your prostate for any irregularities. Dr. Steinberg may ask you about any symptoms you are having, such as any urinary or sexual problems, and how long you have had them. You might also be asked about possible risk factors for prostate cancer, including your family history.
Diagnostic Testing for Elevated PSA
4K Score - Dr. Steinberg often utilizes the 4Kscore, a blood test drawn in the office, which combines four prostate-specific biomarkers with clinical information, to provide men with an accurate and personalized measure of their risk for aggressive prostate cancer. The 4K score can be used to help determine the need for a prostate biopsy. The 4-K score can also help predict the likelihood of cancer spreading to other parts of the body over the next 20 years. The blood sample is sent overnight to a lab and results are usually available and discussed with patients within one week.
Exosome DX Urine Test - This simple urine test performed in the office is often used to determine the risk of finding high-grade cancer on a subsequent prostate biopsy. This information can help guide the decision for recommending a biopsy. Results of the test are usually available in 24 hours. Learn more about the Exosome DX Urine test here.
Prostate MRI - An MRI of the prostate may be recommended if prostate cancer is suspected in order to detect hidden tumors within the prostate in advance of a biopsy.
Biopsy - When considering whether to perform a prostate biopsy to identify cancer, not all doctors use the same PSA cutoff point. Some may advise a biopsy if the PSA is 4 or higher, while others might recommend starting at a lower level, such as 2.5 or 3. Other factors, such as your age, ethnicity, and family history may affect this decision. Dr. Steinberg’s approach considers additional diagnostic factors before recommending a prostate biopsy. If the results of a digital rectal exam, PSA test, 4-K score, Exosome DX test, or Prostate MRI suggest cancer, Dr. Steinberg may recommend a prostate biopsy to definitively determine the presence of cancer.