About one in every 44 men in the United States will die from the disease, making it the #2 cancer killer of men, right behind lung cancer in the #1 spot. However, more than 3.5 million men who’ve been diagnosed with prostate cancer are currently alive.
Those statistics are what drove you to seek a prostate screening with a prostate-specific antigen (PSA) test in the first place. You know that you, like all men, have at least a moderate risk of prostate cancer. And you know that if your doctor finds it soon enough, you have a good chance of curing it or living out your entire normal lifespan without ill effects.
Still, when your PSA levels come back marked “high,” you’re concerned. Elevated PSA levels are concerning, both to you and your urologist, but they don’t mean that you already have prostate cancer.
Expert urologist, Alex Lesani, MD, performs prostate cancer screenings at our Las Vegas, Nevada, office. Even if you don’t think you’re at risk, he encourages you to get a baseline PSA score so that you know what’s normal for you right now.
So what do you do when your PSA levels are elevated? We walk you through the steps below.
Although you’re more likely to have prostate cancer if your PSA levels are elevated, they’re not a clear-cut sign that you actually do have cancer. In fact, there’s not even a specific number that would indicate you’d crossed over from the “benign” category into a precancerous or cancerous one.
What’s normal for your PSA levels might not be so for someone else. Your age, your health, and the medications you take can all influence your final number.
For instance, for most men, levels above 4.0 ng/mL would be considered high. However, young men who should have lower PSA levels may need to undergo a prostate biopsy if their levels are as low as 2.5 ng/mL. In contrast, older men may go as high as 5 ng/mL before we consider that worrisome.
Because many factors can elevate your PSA either temporarily or over the long term, we may recommend another PSA test before exploring other options. On any given screening round, up to 7% of men have a false-positive PSA test. In addition, only a quarter of men who undergo biopsy for high PSAs are found to have cancer. Your PSA levels can rise due to:
You may be scheduled for a retest in about 6-8 weeks. We recommend you avoid activities and medications that could raise your PSA for at least two days before a retest. We may also administer a digital rectal exam (DRE) to see if we can feel a tumor.
If your retest levels are still high, Dr. Lesani may make several recommendations, depending on your unique case.
If Dr. Lesani feels an enlarged prostate on either DRE, but doesn’t find any aberrant lumps, he may diagnose you with BPH. He then helps you shrink the excess tissue to relieve symptoms such as discomfort or urinary incontinence.
Treatment for BPH may include lifestyle changes, medications, or GreenLight™ laser therapy. GreenLight can reduce your pain and also reduce the size of your prostate without any invasive treatment. Your prostate’s smaller size and the relief of symptoms may continue for up to five years.
If Dr. Lesani detects a tumor, his approach to treatment depends on how small it is and your expected lifespan. Prostate cancer grows very slowly, so if you’re elderly or have other health conditions that could end your life within 10 years, he takes a watch-and-wait approach.
For watch-and-wait, he recommends more frequent screenings to monitor the tumor’s size. He only removes the tumor if it grows larger or is in danger of spreading to other areas of your body.
If you’re expected to live longer than 10 years, he may take a biopsy of the tumor to determine whether it is or isn’t cancer. He performs the biopsy with a needle that’s inserted through your rectum or perineum.
The lab then examines the biopsy and grades your tumor from 1-5 (low grade to high grade), and according to a Gleason score of 2-10. High grades and Gleason scores of 6-10 are considered to be cancer; the higher the score, the faster the cancer is growing. We may then remove the tumor and recommend that you for further investigation and treatment
Is it time for a PSA test to rule out prostate cancer or get early treatment? Contact Dr. Lesani at 702-470-2579 today or book your appointment online.
