My Prostate Screening is Abnormal. Now What Should I Do?

Suppose you've just had a screening test for prostate cancer—the PSA (prostate-specific antigen) blood test. Your results are not normal. But what does this really mean?

With many types of cancer tests, you can breathe a sigh of relief if you get a negative result. With a positive test result, you can take action and fight the cancer.

With prostate cancer screening, the results aren't so straightforward. The PSA test may prompt your doctor to look for possible signs of prostate cancer, but it might not indicate that you have cancer for certain.

To find out what your prostate screening results mean, our experts at The Christ Hospital suggest having a good conversation with your doctor. Discuss your cancer risk and whether you need follow-up testing.  

What is the PSA test?

Typically, doctors use the PSA blood test to screen men for possible signs of prostate cancer.

The PSA test measures the prostate-specific antigen in the blood in nanograms per milliliter. (See below.) Generally, your chance of having prostate cancer goes up as the PSA level goes up.

What is a normal PSA test result? What is abnormal?

According to the National Cancer Institute, there is no specific normal or abnormal level of PSA in the blood.

The American Cancer Society uses this guide:  

  • If the PSA level is UNDER 4 nanograms per milliliter, most men do not have prostate cancer. However, it's important to note that a level below 4 does not guarantee that a man is cancer-free.
  • If the PSA level is between 4 and 10, the man has about a 1 in 4 chance of having prostate cancer.
  • If the PSA level is over 10, the chance of having prostate cancer is over 50%.

If your PSA levels rise continuously over time, that may indicate cancer.

What issues (other than cancer) might also raise your PSA levels?

Keep in mind that a high PSA test result does not mean you have cancer. Other non-cancerous conditions can also raise your PSA levels. These include:

  • Inflammation of the prostate
  • Enlargement of the prostate
  • Age (PSA levels are normally higher in older men.)
  • Prostate size
  • Urinary tract infection
  • Prostate stimulation
  • Bicycle riding (Some theorize that the seat puts pressure on the prostate.)

Also, certain medications and dietary supplements can artificially raise or lower PSA levels.

What action should you take if your PSA levels are high?

If your doctor considers your PSA levels to be on the high side, they may recommend some next steps to confirm or rule out a diagnosis of prostate cancer. Your doctor may suggest:
  • Waiting a while and repeating the PSA test
  • Other types of PSA tests
  • A digital rectal exam to check for bumps or hard spots on the prostate
  • An imaging test of the prostate gland, such as MRI or ultrasound
  • A prostate biopsy to detect cancer

According to the American Cancer Society, the prostate biopsy test is the only way to know for certain you have prostate cancer. If the biopsy detects prostate cancer, doctors can examine the cancerous tissue under a microscope. Abnormal tissue—which looks very different than normal prostate tissue—is more likely to grow and spread quickly.

Doctors may also use MRI and other imaging tools to see whether the cancer has spread outside the prostate.

What should I do if my doctor confirms a cancer diagnosis?

If you are diagnosed with prostate cancer, your doctor will need to "stage" it — or determine how advanced it is. Your treatments will depend on how slow or aggressive your cancer is and whether it has already spread.

If the cancer is spreading slowly, there's a chance that you and your doctor will decide that treatment is not necessary.

If you would like more help to interpret your PSA test results—or if you'd like to explore treatment options for prostate cancer—contact The Christ Hospital Physicians - Urology at 513-721-7373.

Justin Cox, MD, with The Christ Hospital Physicians - Urology

As a urologist, Dr. Cox specializes in the surgical and medical treatment of diseases involving the urinary system, with an emphasis in the surgical management of urologic cancers. Dr. Cox has a particular interest in performing robotic-assisted laparoscopic surgeries for urological cancers of the prostate, kidney, and bladder. He is also skilled at performing robotic-assisted surgery for reconstruction of the urinary tract.

My Prostate Screening is Abnormal. Now What Should I Do? What do your PSA test results mean? Learn the indications of potential prostate cancer—and what your next steps might be.

Suppose you've just had a screening test for prostate cancer—the PSA (prostate-specific antigen) blood test. Your results are not normal. But what does this really mean?

With many types of cancer tests, you can breathe a sigh of relief if you get a negative result. With a positive test result, you can take action and fight the cancer.

With prostate cancer screening, the results aren't so straightforward. The PSA test may prompt your doctor to look for possible signs of prostate cancer, but it might not indicate that you have cancer for certain.

To find out what your prostate screening results mean, our experts at The Christ Hospital suggest having a good conversation with your doctor. Discuss your cancer risk and whether you need follow-up testing.  

What is the PSA test?

Typically, doctors use the PSA blood test to screen men for possible signs of prostate cancer.

The PSA test measures the prostate-specific antigen in the blood in nanograms per milliliter. (See below.) Generally, your chance of having prostate cancer goes up as the PSA level goes up.

What is a normal PSA test result? What is abnormal?

According to the National Cancer Institute, there is no specific normal or abnormal level of PSA in the blood.

The American Cancer Society uses this guide:  

  • If the PSA level is UNDER 4 nanograms per milliliter, most men do not have prostate cancer. However, it's important to note that a level below 4 does not guarantee that a man is cancer-free.
  • If the PSA level is between 4 and 10, the man has about a 1 in 4 chance of having prostate cancer.
  • If the PSA level is over 10, the chance of having prostate cancer is over 50%.

If your PSA levels rise continuously over time, that may indicate cancer.

What issues (other than cancer) might also raise your PSA levels?

Keep in mind that a high PSA test result does not mean you have cancer. Other non-cancerous conditions can also raise your PSA levels. These include:

  • Inflammation of the prostate
  • Enlargement of the prostate
  • Age (PSA levels are normally higher in older men.)
  • Prostate size
  • Urinary tract infection
  • Prostate stimulation
  • Bicycle riding (Some theorize that the seat puts pressure on the prostate.)

Also, certain medications and dietary supplements can artificially raise or lower PSA levels.

What action should you take if your PSA levels are high?

If your doctor considers your PSA levels to be on the high side, they may recommend some next steps to confirm or rule out a diagnosis of prostate cancer. Your doctor may suggest:
  • Waiting a while and repeating the PSA test
  • Other types of PSA tests
  • A digital rectal exam to check for bumps or hard spots on the prostate
  • An imaging test of the prostate gland, such as MRI or ultrasound
  • A prostate biopsy to detect cancer

According to the American Cancer Society, the prostate biopsy test is the only way to know for certain you have prostate cancer. If the biopsy detects prostate cancer, doctors can examine the cancerous tissue under a microscope. Abnormal tissue—which looks very different than normal prostate tissue—is more likely to grow and spread quickly.

Doctors may also use MRI and other imaging tools to see whether the cancer has spread outside the prostate.

What should I do if my doctor confirms a cancer diagnosis?

If you are diagnosed with prostate cancer, your doctor will need to "stage" it — or determine how advanced it is. Your treatments will depend on how slow or aggressive your cancer is and whether it has already spread.

If the cancer is spreading slowly, there's a chance that you and your doctor will decide that treatment is not necessary.

If you would like more help to interpret your PSA test results—or if you'd like to explore treatment options for prostate cancer—contact The Christ Hospital Physicians - Urology at 513-721-7373.

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