In short
- PSA is a protein made by the prostate; its level rises with age and prostate size.
- A raised PSA can come from an enlarged prostate, inflammation or infection, not only from cancer.
- The first step is often to repeat the test, then to have a prostate MRI if doubt remains.
- A biopsy is only offered if the results justify it.
In this article
What is PSA?
PSA (prostate-specific antigen) is a protein made by the prostate, measured with a simple blood test. The normal level varies with age and prostate size: there is no single cut-off that applies to everyone, and the urologist interprets the result in light of your situation.
Why can PSA be raised?
Several causes, often benign, can push PSA up:
- A prostate that enlarges with age (benign enlargement), very common after 50
- Inflammation or infection of the prostate (prostatitis), or a urinary infection
- A recent procedure on the prostate or bladder (catheter, cystoscopy, biopsy)
- Prostate cancer, which needs to be looked for without jumping to conclusions
What will the urologist do?
The urologist asks about your history, examines you and checks for infection. Often a repeat test is requested a few weeks later. If PSA stays high or keeps rising, a prostate MRI can show whether there is a suspicious area.
A biopsy is only offered if the MRI or other findings justify it. This approach avoids many unnecessary tests.
Should I be screened?
PSA testing in men without symptoms is decided case by case, after clear information on its benefits and limits. European guidelines suggest discussing it from age 50, or from 45 for men with a family history of prostate cancer or of African descent.
When should I book an appointment?
As soon as your doctor considers your PSA raised, or if it goes up from one test to the next. A raised PSA with fever and burning when passing urine suggests prostatitis and needs prompt attention.
What is a prostate MRI like?
The scan takes about thirty minutes, with no pain and no hospital stay. The radiologist gives each area a suspicion score (called PI-RADS): the higher it is, the more likely a significant lesion. The urologist then decides the next steps with you.
Monitoring PSA over time
When tests are reassuring, PSA monitoring is often suggested, at a pace suited to your situation. Keep your successive results: the trend over time matters more than a single value.
Frequently asked questions
Does a raised PSA mean I have cancer?
No. Most raised PSA results are explained by an enlarged prostate or inflammation. Only further tests can tell.
Is a biopsy always needed?
No. A prostate MRI often avoids unnecessary biopsies; one is offered if the MRI or the PSA trend justifies it.
Can I lower my PSA?
Treating an infection or prostatitis brings it down. Some medicines for an enlarged prostate also lower it, which the urologist takes into account. No diet “normalises” PSA.
Learn more
- CareProstate cancerProstate cancer is the most common cancer in men.
- CareProstate: enlargement, PSA, prostatitisThe prostate grows with age in most men.
- CareProstatitisProstatitis is inflammation of the prostate, most often caused by an infection.
- CareProstate biopsyA prostate biopsy takes small samples of the prostate for analysis.
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Article published by Dr Ayhan Bakar, urologist in Brussels (INAMI 17718534450).
Reference: European Association of Urology (EAU) guidelines.