Seeing an elevated PSA result can immediately bring up questions: Does this mean I have prostate cancer? Will I need more testing? Am I going to need a biopsy?
An elevated PSA does not automatically mean prostate cancer. PSA levels can be affected by several factors, and the result is one piece of information your urologist may use to determine whether additional evaluation is needed.
During Prostate Cancer Awareness Month, Kansas City Urology Care (KCUC) is helping men and their families better understand what an elevated PSA can mean, what may happen next, and what questions to ask along the way.
What Does an Elevated PSA Mean?
PSA stands for prostate-specific antigen, a protein produced by the prostate gland. A PSA blood test measures the amount of PSA in your blood.
Higher PSA levels can sometimes be associated with prostate cancer, but cancer is not the only reason PSA may be elevated. PSA levels may also be affected by benign prostatic hyperplasia (BPH), commonly called an enlarged prostate, as well as inflammation or infection involving the prostate. That is why an elevated PSA result should be considered alongside other information about your health rather than viewed as a prostate cancer diagnosis by itself. Schedule an appointment with KCUC to learn more.
Does an Elevated PSA Always Mean Prostate Cancer?
No, an elevated PSA alone cannot determine whether you have prostate cancer. Your urologist may consider several factors when evaluating your result, including your PSA level, how that level has changed over time, your age, family and medical history, prostate health, symptoms and other individual risk factors. The important next step isn’t assuming an elevated result means cancer. It’s determining why the PSA may be elevated and whether additional evaluation is appropriate. Contact KCPI to explore your treatment options.
What Happens Following an Elevated PSA Result?
There isn’t one identical next step for every patient. Depending on your PSA result and individual circumstances, your physician may recommend additional evaluation before determining whether a prostate biopsy is necessary. That process may include reviewing previous PSA results, considering your medical and family history, performing a physical examination or recommending additional testing or imaging.
When more information is needed, a prostate MRI may help physicians evaluate the prostate more closely. If an area of concern is identified, your urologist may recommend a prostate biopsy to determine whether cancer cells are present. The goal is to gather enough information to understand what may be causing the elevated PSA without drawing conclusions from a single blood test. Request an appointment with KCUC today to get started with advanced, personalized treatment.
Why Might My Urologist Recommend a Prostate MRI?
A prostate MRI provides detailed images of the prostate that can help physicians identify areas that may need closer evaluation. The information from an MRI can become another piece of the diagnostic picture. Depending on the findings and other individual factors, your urologist may determine that continued monitoring is appropriate or recommend additional testing such as a prostate biopsy.
If imaging identifies a suspicious area, MRI-ultrasound fusion technology can help physicians use the information captured during the MRI to more precisely target areas of concern during a biopsy. Not everyone with an elevated PSA will need an MRI or biopsy. Your physician can determine which diagnostic steps are appropriate based on your individual circumstances.
When Might a Prostate Biopsy Be Recommended?
A prostate biopsy is used to determine whether prostate tissue contains cancer cells. During a biopsy, small samples of prostate tissue are collected and then examined by a pathologist. When previous imaging has identified an area of concern, fusion-biopsy technology can help physicians target that specific area.
KCUC offers MRI-ultrasound fusion biopsy, which combines information from MRI imaging with real-time ultrasound to assist physicians in targeting suspicious areas of the prostate. A recommendation for a biopsy still does not mean that prostate cancer has been diagnosed. The biopsy provides additional information physicians can use to determine whether cancer is present.
What Happens If Prostate Cancer Is Found?
If testing confirms prostate cancer, the conversation changes from “Why is my PSA elevated?” to understand the characteristics of the cancer and determine which treatment options may be appropriate. Treatment planning is individualized. Factors such as the characteristics and extent of the cancer, PSA results, overall health and personal preferences can all play a role in determining the next step.
Depending on the individual diagnosis, prostate cancer care may include approaches such as active surveillance, surgery, radiation therapy or other treatments. Rather than trying to cover every treatment option here, the next step is learning about the choices that may be appropriate for your particular diagnosis and discussing them with your expert care providers at KCUC.
Considering Radiation Therapy?
For patients considering radiation treatment for prostate cancer, KCUC also works with Kansas City Proton Institute (KCPI) in Overland Park, Kansas. Proton therapy is a type of radiation therapy that may be an option for appropriate patients with prostate cancer.
Frequently Asked Questions About Elevated PSA
Can PSA Be Elevated Without Prostate Cancer?
Yes. An elevated PSA can occur for reasons other than prostate cancer. Conditions affecting the prostate, including benign prostatic hyperplasia (BPH), inflammation or infection, can also affect PSA levels. KCUC can provide further examination in the context of your overall prostate health and individual risk factors.
Does an Elevated PSA Mean I Need a Biopsy?
Not necessarily. KCUC may consider your PSA results, medical history, risk factors, physical examination and additional testing before determining whether a biopsy is appropriate. Get in touch with KCUC to learn more.
Can My PSA Level Change Over Time?
Yes. PSA levels can change, which is one reason your physician may consider previous PSA results and changes over time rather than evaluating a single number in isolation. Schedule an appointment with KCUC today.
Why Would My Urologist Order a Prostate MRI?
A prostate MRI provides detailed images of the prostate and can help physicians identify areas that may require additional evaluation. MRI findings can also be used to help target suspicious areas if a biopsy is recommended.
What Is an MRI-Ultrasound Fusion Biopsy?
MRI-ultrasound fusion biopsy combines previously captured MRI information with ultrasound imaging during a biopsy. This helps the physician more precisely target areas of the prostate that appeared suspicious on MRI. Learn More About KCUC’s MRI-Ultrasound Fusion Biopsy
What Happens If My Biopsy Finds Prostate Cancer?
If prostate cancer is found, your physician will review the characteristics of the cancer and discuss appropriate next steps with you. Treatment recommendations vary based on the individual diagnosis and may include active surveillance, surgery, radiation therapy or other treatment approaches.
Sources & Additional Resources
- National Cancer Institute – Prostate Cancer
- National Cancer Institute – Prostate-Specific Antigen (PSA) Test
This information is intended for educational purposes and should not replace individualized medical advice. Talk with your healthcare provider about questions regarding PSA testing, prostate cancer screening, diagnosis or treatment.