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. Motola,
Can sexual activity just before a PSA blood test make PSA results jump from 2 to 12?
PSA testing immediately after sexual activity remains controversial. The most widely held belief is that patients should wait 3 days after sexual activity prior to obtaining a PSA, however some recent studies suggest that sexual activity will not cause a rise. Repeating the PSA after 3 days of abstinence will be the easiest way to resolve this.
Dear Dr. Motola:
What is the normal PSA for a 69 year-old man? At what level does the PSA become troubling or warrant further tests?
PSA cut off levels have been debated for many years. Traditionally the cut off for a normal PSA has been 4, however more recently age-adjusted PSA values are being advocated. Utilizing age-adjusted PSA values helps to explain that the PSA of a 45-year-old should be different than that of a 70-year-old. A PSA less than 3.5 is usually considered normal for men age 55 or younger. Similarly as patients get into their mid 70s, higher values of PSA are now being accepted without the need for the patient to undergo biopsy.
Rather than utilizing the absolute PSA value, the rate of change of the PSA is a very important variable. PSAs that are rising at a very rapid rate are more like to be associated with prostate cancer . A PSA increase of more than 0.75 per year may also be indicative of underlying prostate cancer. Furthermore,...
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