A man goes to the doctor for his regular checkup. Everything comes back fine except he is told his prostate specific antigen (PSA) level is elevated. Does this automatically mean he has prostate cancer? The simple answer to this is no. An elevated PSA number does not always indicate a man has prostate cancer.
It is often the first step in screening for prostate cancer along with the second screening test which is a digital rectal exam (DRE). A man’s PSA level can vary depending on many factors which include his age, race, and family history of prostate diseases such as prostatitis.
In a man without prostate cancer, the PSA level should be 4.0 ng/mL or less. Changes of more than 2.0 ng/mL over the course of a year could be an indicator of the presence of prostate cancer.
When a man has an elevated PSA number, it needs to be assessed along with other risk factors that can elevate the PSA levels which may include the following:
- Diet – a diet high in saturated fat along with obesity can increase prostate cancer.
- High testosterone levels – men who use testosterone therapy are more likely to develop prostate cancer as an increase in testosterone stimulates the growth of the prostate gland
- Medications – some medications like Proscar, Avodart, or Propecia can falsely lower a man’s PSA level.
- Ejaculation – A man should refrain from sex or ejaculating for at least 24-48 hours before a PSA test as sex can cause a mild increase in the PSA number.
Do not assume right away that a high PSA is automatically prostate cancer. There are many different causes for an elevated PSA.