Is My PSA Level Normal? The absolute value of PSA has been the long-term standard of care to determine whether one’s PSA elevation is significant. Previously, the magic number of “4” was defined as being the upper limit of “normal.” However, this may not be a good rule of thumb since approximately 15% of prostate cancers can occur in men with a “normal” PSA. When interpreting a PSA value, several factors need to be taken into consideration—not just the absolute value of the PSA. Some of these factors include: Age adjustment of the PSA PSA density Percent free PSA PSA velocity Age-Adjusted PSA Recent data has redefined the way that urologists look at PSA, and what is considered a "normal" PSA. Age-adjusted PSA values take into account that a 40-year-old should not have the same PSA as an 80-year-old. Accepted age-adjusted PSA rates are below 2.4 ng/ml for men under...
Dear Dr. Greenstein:
My friend ,who is in his early 50s, just got the results of his annual PSA test - it was between 4-5. The results of his previous 6 annual tests were in the 1-2 range every year, until now. His brother recently had his prostate removed due to cancer.
He now has to see a specialist. We are both very concerned, but should we be that worried?
First, I never tell people to worry before we have all the answers. In this situation, it is crucial to know if this man has any new voiding problems such as burning, slow stream or the sensation he is not emptying his bladder. These symptoms can indicate prostate inflammation, which can falsely elevate the PSA value. In those cases, a course of antibiotics are warranted and the PSA can be repeated after finishing the antibiotics.
If the PSA normalizes then this man can continue to have his prostate examined every 6 - 12 months. The physical exam is also very important. The discovery o...
A 62-year-old patient had surgery to remove his cancerous prostate gland about 6 years ago. Two years after surgery his PSA started to rise and now his PSA is 4.6 ng/ml.
I hate to say it but, it is clear that this patient has failed surgery and has "biochemical failure." In other words, his prostate was removed but there is something in his body making his PSA go up and probably more cancerous cells in his body. Even though he feels fine, this rise in PSA is the only sign that his prostate cancer is trying to return. There are two places were cancer can return: 1) in the pelvis where the prostate used to be located, or 2) elsewhere in the body, suggesting that the cancer has spread. Unfortunately, this is a fairly common problem. Up to 30% of men will not be cured by surgery alone and they will have a rise in their PSA months or years after the prostate is removed. That is why it is crucial for men to have their PSA checked on a regular basis after treatment.
There are f...
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