Understanding PSA

Your PSA level is in the normal range. This is a reassuring result. You have a low risk of being diagnosed with prostate cancer within the next few years.

Consider having your test repeated in one to two years.

You have reached the end of this guide. What would you like to do?

• Go back to the beginning of this guide.
• Learn more about PSA testing.
• Learn more about prostate cancer.

Understanding PSA

Your PSA level is very low. This is a reassuring result. You have a very low risk of being diagnosed with prostate cancer within the next few years.

Recent research suggests that it’s probably safe to wait two years before having your PSA checked again.

You have reached the end of this guide. What would you like to do?

• Go back to the beginning of this guide.
• Learn more about PSA testing.
• Learn more about prostate cancer.

Understanding PSA

Your PSA level is in the normal range. This is a reassuring result.

Consider having your test repeated in one to two years.

You have reached the end of this guide. What would you like to do?

• Go back to the beginning of this guide.
• Learn more about PSA testing.
• Learn more about prostate cancer.

Understanding PSA

Your PSA level is above four ng/ml. In younger men, this is usually considered to be a worrisome level. However, your PSA level may be normal for someone in your age group.

Speak with your doctor about options for follow-up, including

• referral to a urologist (prostate specialist)

Understanding PSA

Your PSA level is in the normal range. This is a reassuring result.

Given your age or medical history, many doctors would question whether it makes sense to have your PSA tested regularly. This is because prostate cancer is often a slow-growing disease, especially in older men. Even if prostate cancer is detected, the risks of side effects from treatment may be greater than any potential benefits.

Speak with your doctor about whether it makes sense to continue being screened for prostate cancer on a regular basis.

Understanding PSA

Your PSA level is above the normal range. However, given your age or medical history, further evaluation may or may not be worthwhile. Speak with your doctor about appropriate follow-up.

Your options include

• a “watch and wait approach” with repeat testing in several months
• referral to a urologist (prostate specialist)

You have reached the end of this guide. What would you like to do?

• Go back to the beginning of this guide.

Understanding PSA

Next, we need to know your most recent PSA test result. Usually this is a number between 1.0 and 10.0 (PSA is measured in nanograms per milliliter, or ng/ml).

What was your most recent PSA level?

• Less than 1.0
• 1.0 to 3.99
• 4.0 to 6.49
• 6.5 to 9.99
• 10 or higher

Understanding PSA

Most doctors recommend waiting until age 50 to start PSA testing. That’s because prostate cancer is uncommon before this age. However, PSA levels are sometimes checked in men younger than age 50 because they have a risk factor for prostate cancer, such as having a close family member with the disease or being African-American (African American men are more likely than other men to develop prostate cancer and can develop an aggressive form of the disease at a young age).

Understanding PSA – Introduction

Welcome to this Decision Guide about PSA testing.

Prostate-specific antigen, or PSA, is a blood test used by many doctors to screen for prostate cancer. If you’ve had your PSA level checked, you may have been told that your results were “normal” or “abnormal.” However, some men would like to know more about what their PSA level means.

This tool provides more information about PSA levels, and what’s considered to be reassuring or worrisome for men of different ages.

Transrectal ultrasonography (TRUS) can create images of the prostate gland using sound waves. Doctors may recommend TRUS when they suspect prostate cancer based on an abnormal DRE or an elevated PSA.

Researchers are developing more screening tests for prostate cancer. Like the PSA test, they rely on biomarkers, such as antigens or proteins, which are elevated or may only be present in men who have prostate cancer. The hope is that these newer tests will better detect existing cancers (better sensitivity), and will not raise the alarm for cancer when it is not present (better specificity).

In this test, the doctor inserts a lubricated, gloved finger into the rectum and feels the surface of the prostate to determine whether it is swollen or has any lumps or abnormally textured areas (see Figure 1). This exam also helps doctors screen for diseases of the rectum, such as rectal cancer.

This imaging technique, which uses a powerful magnet and a computer to generate pictures of the body’s organs and tissues, can be used to diagnose prostate cancer or pinpoint the tumor’s location.

Prostate

Prostate

The National Cancer Institute discontinued the study after finding evidence that selenium and vitamin E supplements did not prevent prostate cancer.

The jury is still out on whether intermittent hormone therapy, which involves repeated cycles of hormone therapy followed by breaks in treatment, might help patients live longer than continuous hormone therapy. But Patrick Kirby’s story might help patients who are debating various options in hormone therapy.

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Dr. Abraham Morgentaler, an associate professor of surgery at Harvard Medical School and the director of Men’s Health Boston, shares his views on current controversies regarding testosterone-replacement therapy.

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A look at treatment options and trade-offs

If you are like many of the 14 million men in the United States who have been diagnosed with benign prostatic hyperplasia (BPH), you’ve probably been taking the same medication, at the same dose, for years. If so, consider the experiences of two patients, both of whom were taking some type of medication for BPH. Their names have been changed, but all other details are accurate (see “Jack Muriel” and “Henry Banks”).

Penile implants, an option patients with erectile dysfunction probably hear little about, might offer a lasting and satisfying “cure.” Abraham Morgentaler, M.D., director of Men’s Health Boston, explains how.