Each year, about half of men over age 50 receive a PSA (prostate specific antigen) screening, according to the Centers for Disease Control. PSA is a protein produced in the prostate, and high levels of PSA may indicate cancer. About 10 percent of men tested receive results that indicate elevated levels of PSA. Often, when elevated PSA levels are detected, your physician will recommend a biopsy. The good news is, nearly three quarters of those biopsies will show no cancer.
In most cases, if the biopsy results are negative, meaning no cancer is detected, no additional diagnostic testing will be necessary. But you should seek further testing in some circumstances, such as if you have:
- A family history of prostate cancer
- Other symptoms
- Multiple elevated PSAs
- Other risk factors
- Stress and worry
You and your physician may decide the best course of action is to test your PSA levels every three to six months to monitor them. If your PSA levels continue to go up, your physician may recommend a repeat biopsy in a few months.
If your initial biopsy results were negative, work with your doctor—whether it’s your primary care physician or a trusted specialist —to develop a follow-up plan. Your physician will also look for other causes that might explain the elevated PSA levels. Other potential causes include benign prostatic hypertrophy (BPH), a very common condition among older men, which causes your normal prostate tissue to grow. Since that tissue produces PSA, your levels will naturally—but harmlessly—rise. In addition, the prostate may be inflamed due to infection or other causes.
If PSA continues to behave suspiciously despite no cancer apparent on the initial biopsy, other diagnostic tests can be utilized. These include genomic biomarkers and advanced prostate imaging with MRI. You can discuss these options with your urologist.
Learn more about choosing the right treatment for prostate cancer in this blog.
If you're considering prostate surgery, download a free guide to learn more about robotic prostatectomy.
A board-certified urologist, Derek K. Zukosky, DO, specializes in minimally invasive urological procedures. One of the most experienced and highly trained robotic surgeons in the Denver area, Dr. Zukosky specializes in robotic prostatectomies. He also has a special emphasis in prostate cancer, BPH, urinary stone disease, kidney cancer, urolithiasis, and men’s sexual health including erectile dysfunction.