Elevated PSA

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What You Should Know If Your PSA Is Elevated

Prostate specific antigen, also known as PSA, are proteins made in the prostate. They circulate in the bloodstream. A blood test can indicate if your PSA level is elevated which could indicate an enlarged prostate (BPH), urinating issues, infection of the bladder or prostate cancer.

Overview

What is Elevated PSA?

Prostate specific antigens are made by prostate cells. They help keep semen liquified so sperm can swim. Both noncancerous and cancerous prostate cells make PSA, but cancerous cells tend to produce more, and some excrete into the bloodstream. As a result, men with prostate cancer usually have high PSA levels, which the PSA blood test measures and screens.

High levels of PSA do not always mean cancer, and normal PSA levels do not guarantee cancer is not present. High levels of PSA may also result from an enlarged prostate (BPH) or prostatitis (prostate infection), urinating issue, or a bladder infection. However, combined with the digital rectal exam, a PSA screening remains the best way to detect prostate cancer.

After prostate cancer is detected, PSA testing also can help determine the best treatments and prognosis.

Symptoms

What are the symptoms of Elevated PSA?

Oftentimes there are no symptoms associated with an elevated PSA; however, symptoms can include:

Sudden change in urinary symptoms
Urinary tract infection symptoms (i.e., burning with urination, urinary frequency or urgency, lower abdominal discomfort, or pelvic pain)

Cause

What causes Elevated PSA?

While there are many different causes for an elevated PSA, it is most commonly due to one of the following: enlarged prostate (BPH), prostate cancer, urinary tract infection, inflammation, or trouble with urination.

Diagnosis

How is Elevated PSA diagnosed?

What to know before your visit to MidLantic Urology in Philadelphia and surrounding counties:

During your visit your doctor will ask you questions regarding your medical history and will perform an exam with focused attention to the abdomen and genitalia. A digital rectal examination may also be necessary to thoroughly examine the prostate. Information regarding PSA history, personal and family cancer history, and voiding complaints will also be discussed.

Tests that may be performed during or after your visit:

Urinalysis: this evaluates for any blood in the urine or infection
Post-void residual: The physician will often ask you to void and then check to make sure you are emptying your bladder.
Imaging may be performed: An MRI prostate involves an MRI of the pelvis and prostate. It may include contrast material and may involve placement of a probe into the rectum to aid in taking pictures of the prostate (but not always). The procedure typically lasts 30-45 minutes.
Additional blood work will often be performed
Prostate needle biopsy (see Treatment)

Treatment

How do you treat Elevated PSA?

Prostate needle biopsy:

Transrectal prostate biopsy: This involves placement of an ultrasound probe into the rectum. We then measure the size of the prostate, provide local anesthetic, and perform biopsies of the prostate (typically 12 biopsies, but occasionally more). The procedure lasts approximately five minutes.

Transperineal prostate biopsy: This involves placement of an ultrasound probe in the rectum. However, instead of taking biopsies through the rectum, biopsies are taken through the skin located between the scrotum and the rectum (typically 12 biopsies are taken, but occasionally more). The procedure lasts approximately 10-15 minutes. This has been associated with lower infection rates and higher cancer detection rates.