Prostate-specific antigen (PSA) is a protein that the cells in your prostate gland produce. Both normal cells and malignant (i.e., cancer) cells produce PSA. When you have an elevated PSA level, it could be a sign that you have malignant cells producing extra PSA.
Although an elevated PSA goes hand-in-hand with prostate cancer, the opposite isn’t always true. Other conditions may cause your high PSA values as well.
Our expert urologist, Alex Lesani, MD, recommends regular PSA tests based on age and risk level for men over 40 years old. Keeping tabs on your PSA production means you and your doctor can detect any possible problems or changes as early as possible. When it comes to prostate cancer, early detection often leads to a cure.
What do you do if your doctor says your PSA levels are elevated? Here’s a brief description of what comes next.
You may need more tests
If you had a baseline PSA test previously, Dr. Lesani first compares your new results to your prior ones to see if your elevated PSA is elevated for you. As with other measurements, normal for one man might be slightly high or low for another.
When your PSA score rises more than 0.35 ng/ml in a year, Dr. Lesani may recommend another PSA test to confirm the results. If you didn’t have a prior PSA test, and your levels are high, he immediately conducts another one.
Dr. Lesani may also conduct a digital rectal exam (DRE), in which he inserts a gloved finger into your rectum to determine your prostate’s size and to see if it contains any lumps. An enlarged prostate is one of the more common reasons for an elevated prostate.
Depending on his findings, he may recommend regular PSA and DRE tests to make sure they don’t spike. If your PSA continues to rise or Dr. Lesani palpates a lump on your prostate, he may order imaging studies, such as an MRI or micro-ultrasound. He may also perform a biopsy, removing a small portion of the lump to examine it for cancer cells.
The next steps depend on diagnosis
Depending on the results of the tests, Dr. Lesani makes a diagnosis. The two main conditions behind elevated PSAs are an enlarged prostate and prostate cancer.
If you have an enlarged prostate, also known as benign prostatic hyperplasia (BPH), Dr. Lesani works with you to help you shrink the excess tissue. In addition to causing discomfort and symptoms, such as urinary incontinence and pain, an enlarged prostate makes it difficult to detect cancerous lesions. Treatments and recommendations include:
- Limit caffeine and alcohol
- Limit liquids at night
- Urinate regularly
- Exercise more
- Eat whole foods
- Laser therapy
Dr. Lesani starts with the least invasive therapies first. GreenLightTM laser therapy, an in-office procedure, may give you immediate relief. Afterward, you may be able to discontinue BPH medications. The results can last at least two years and possibly up to five years.
The only good thing about prostate cancer is that it grows very slowly. That’s why catching it early often leads to a cure. Depending on how advanced your cancer is, treatment could include:
- Watch and wait
- Radiation and chemotherapy
- Hormone therapy
If you decide to remove your prostate, Dr. Lesani takes a minimally invasive approach with da Vinci® robotic surgery.
Start screening now
Getting a baseline PSA test before you develop symptoms of BPH or prostate cancer means we’re better able to track your individual levels and identify problems as soon as possible. The American Cancer Society recommends that you start screening by age:
- 40, if more than one first-degree relative had prostate cancer before age 65
- 45, if you’re African American, or at least one first-degree relative had prostate cancer before 65
- 50, if you’re at average risk (everyone else)
Establish your normal PSA levels or determine if they’re high by scheduling a PSA test today. Call our helpful team at 702-470-2579 or book your appointment online.