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ASK THE EXPERTS

WAYNE WALTZER, MD.

Patient Question

I am a 55 year-old man. At my annual medical exam, my doctor told me that my PSA level is elevated. What does this mean?


WAYNE WALTZER, MD.
WAYNE WALTZER, MD.
Professor & Chair
Department of Urology
Expert Answer

About the PSA Test
Prostate-specific antigen (PSA) is a protein produced in the prostate gland. The PSA test measures the level of PSA in a man's blood. Because it can be used to detect disease, it is sometimes called a biological marker or tumor marker. It is normal for men to have low levels of PSA in their blood.

There are many possible reasons a man may have an elevated PSA level. An elevated level may indicate the presence of prostate cancer or benign (non-cancerous) conditions such as benign prostate enlargement, inflammation, and infection. A man's age and race may also contribute to an elevated level.

PSA levels alone do not give doctors enough information to distinguish between benign prostate conditions and cancer.

The doctor will consider the PSA results when deciding whether to evaluate further for prostate cancer. Men should always discuss elevated PSA test results with their doctors.

Following up
If a man has an elevated PSA, but no other symptoms suggest cancer, our doctors at Stony Brook University Hospital may recommend repeating a digital rectal exam (DRE) and PSA test regularly to watch for any changes. If a man's PSA level has been increasing or if a suspicious lump is detected during the DRE, the doctor may recommend a biopsy to determine if cancer is present in the prostate. During a biopsy, samples of prostate tissue are removed, usually with a needle, and viewed under a micrscope. The doctor may use ultrasound to view the prostate during the biopsy.

When should I be tested?
African-American men and men with a family history of prostate cancer are at a higher risk of developing prostate cancer. Men who are at higher risk should start being tested at the age of 45. Men at low risk of developing prostate cancer should begin testing by age 50. Medical testing includes the PSA test and a digital rectal exam. Each should be administered by your doctor once a year.


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