David Grossklaus, MD, Urology, Banner Baywood Medical Center
Question: My doctor told me my Prostate Specific Antigen (PSA) is high. Does this mean I have prostate cancer?
Answer: Not always. PSA is a tumor marker used to identify men who are at risk for prostate cancer. PSA is used in a physical examination of the prostate to determine which men need a prostate biopsy. A prostate biopsy is the only way to know if a man has prostate cancer. Unfortunately, PSA is not a perfect test. PSA values can fluctuate depending on many factors, including:
- Infection or inflammation of the prostate
- Benign growth of the prostate or Benign prostatic hyperplasia (BPH)
- Sexual activity
- Catheterization of the bladder
- Prostate cancer
To improve the accuracy of PSA, physicians have used serial examinations where the PSA can be tracked over time. If the PSA goes up by more than one point in a year, the risk of cancer is elevated and a biopsy may be warranted. Also, more specific blood tests, like a Free to Total PSA ratio can be used to determine the risk of prostate cancer and the potential need for a biopsy. In general, if you have a PSA over 4.0 or it rises more than one point in a year, you need to see your primary doctor or a urologist for an evaluation.