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Elevated PSA

Prostate-specific antigens (PSAs) are proteins made by the prostate cells to help keep semen liquified so sperm can swim. Both cancerous and non-cancerous cells make PSA but, cancerous cells usually produce more, so elevated PSA levels in a blood test may indicate the presence of prostate cancer.

What are the causes of an elevated PSA?

Although prostate cancer may be a cause for elevated PSA blood levels, it does not always mean cancer is present. Prostatitis (infection/inflammation of the prostate) and Benign Prostatic Hyperplasia (BPH-enlarged prostate) can also cause higher-than-normal PSA levels. It is important to have a digital rectal exam (DRE) performed by our specialists to help detect prostate cancer.

Some common conditions this symptom is linked to include:

Enlarged Prostate / BPH

Prostatitis

Prostate Cancer

Are there other secondary prostate tests available?

To help you and your physician fully understand next steps, our urologists may suggest further prostate testing.

PSA free-to-total-ratio, or prostate health index (PHI): can help improve the accuracy of the standard PSA test by discerning whether your risk of having prostate cancer is as low as 10% or as high as 50%

PSA velocity: If you’ve had previous PSA tests, your physician will look at them to determine how quickly your PSA levels have changed over time. A steep PSA level increase over a short period (an increase of higher than 0.7 nanograms of PSA per milliliter of blood per year) may often correlate with a prostate cancer diagnosis

Urine tests: One of which detects PCA3, a noncoding RNA gene that is only in your prostate. Too many copies of PCA3 in the urine indicate a greater chance of having prostate cancer

MRI of the prostate to image for biopsy targets

Based on any of these results, our urologists may recommend an ultrasound-guided prostate biopsy if they suspect cancer. The providers at Urology of North Florida will take samples of the prostate and have them analyzed under microscope by specialized pathologists to look for any cancer cells.

American Urological Association’s Guideline’s for Early Detection of Prostate Cancer
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