Does an elevated PSA score mean I have prostate cancer?

An elevated prostate-specific antigen (PSA) score does not necessarily mean that you have prostate cancer. The PSA score may mean you have prostatitis or even a benign enlarged prostate.
Penn Medicine
Administration
The prostate gland produces a protein called prostate-stimulating antigen, or PSA.
Often, PSA levels will begin to rise before there are any symptoms of prostate cancer. Sometimes, an abnormal digital rectal exam may be the only sign of prostate cancer (even if the PSA is normal). If you have an elevated PSA, your doctor may have recommended a biopsy to tell if you have prostate cancer.
PSA (prostate-specific antigen) is a substance made by the prostate gland. Although PSA is mostly found in semen, a small amount is also found in the blood. Most healthy men have levels under 4 ng/mL (nanograms per milliliter) of blood. The chance of having prostate cancer goes up as the PSA level goes up. If your level is between 4 and 10, you have about a 1 in 4 chance of having prostate cancer. If it is above 10, your chance is over 50%. But some men with a PSA below 4 can also have prostate cancer.
Factors other than cancer can also cause the PSA level to go up, including:
  • An enlarged prostate like BPH (benign prostatic hyperplasia--not cancer), that many men get as they grow older.
  • Age: PSA levels go up slowly as you get older, even if you have no prostate changes.
  • Infection or inflammation of the prostate gland (prostatitis).
  • Ejaculation can cause the PSA to go up for a short time, and then go down again.
  • Riding a bicycle
  • Certain urology tests
Some things can cause PSA levels to go down, even when cancer is present:
  • Certain medicines used to treat BPH or urinary symptoms. You should tell your doctor if you are taking medicines for these problems, because the doctor will need to adjust the reading.
  • Some herbal mixtures that are sold as dietary supplements may also hide a high PSA level. This is why it is important to let your doctor know if you are taking any type of supplement--even ones not meant for prostate health. Saw palmetto (an herb used by some men to treat BPH) does not seem to affect the measurement of PSA.
  • Obesity: Very overweight men tend to have lower PSA levels.
  • Aspirin: Men taking aspirin regularly tend to have lower PSA levels. This effect is most pronounced in non-smokers.
Dr. Michael Roizen, MD
Internal Medicine
An elevated PSA score (on a prostate specific antigen test) doesn't necessarily mean you have prostate cancer; a high score can also be associated with other conditions, like benign inflammation of the prostate. Only a biopsy can determine whether it's prostate cancer or not. You and your doc should agree on a course of action you will follow if you have an abnormal reading before you get the PSA test. It is the change from your baseline PSA value rather than the absolute number that interest the doctors; the trend can predict early cancer that most responds to treatment.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.