The wait for a prostate-specific antigen (PSA) test result can be unsettling. This stress, often called “PSA anxiety,” stems from the test’s connection to cancer screening. The uncertainty of what the results might mean can be a significant source of distress for men and their families.
The Purpose of the PSA Test
Prostate-Specific Antigen (PSA) is a protein produced by cells within the prostate gland. This small gland, about the size of a walnut, is part of the male reproductive system and produces some of the fluid in semen. While most PSA is in semen, it is normal for small amounts to circulate in the bloodstream. A PSA test is a blood draw that measures the concentration of this protein.
Doctors use the PSA test as a screening tool to monitor prostate health and help detect potential problems, including cancer, at an early stage. The test itself does not diagnose any specific condition; rather, it provides a data point for a doctor to consider. It is often used alongside a digital rectal exam (DRE) to evaluate the prostate’s overall condition.
An elevated PSA level can be an early indicator of prostate cancer, but it is not a definitive sign. Many other non-cancerous conditions can also cause PSA levels to rise. Because of this, the test serves as a starting point for a conversation with a healthcare provider to determine if further investigation is needed.
Factors That Can Elevate PSA Levels
One of the most common reasons for an elevated PSA level is benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland common in men over 50. As the prostate grows, its cells produce more PSA, leading to a higher concentration in the bloodstream. BPH does not increase cancer risk, but its symptoms can sometimes overlap.
Prostatitis, the inflammation or infection of the prostate gland, is another frequent cause. This irritation, which can result from a bacterial infection, triggers an increased release of PSA into the blood. Treating the underlying infection or inflammation with medication can often cause PSA levels to return to their normal range.
Certain physical activities can cause a temporary spike in PSA. Recent ejaculation can lead to a short-term increase, which is why some doctors advise abstaining for a day or two before the test. Vigorous exercise that puts pressure on the prostate, such as long-distance cycling, may also elevate readings as the pressure is thought to release more protein.
Urological procedures can directly affect PSA results. Recent instrumentation of the urinary tract, like inserting a catheter or a cystoscopy, can irritate the prostate and cause a rise in PSA. Even a digital rectal exam before a blood draw can cause a minor increase, so blood for a PSA test is often drawn first.
A man’s age is also a factor in what is considered a typical PSA level. It is normal for PSA levels to gradually increase as men get older, and this is not necessarily a sign of a health problem. Doctors take age into account when interpreting results, often using age-specific reference ranges.
Managing Anxiety Before and After the Test
Waiting for a PSA test or its results can be a source of stress. A helpful step is to seek out credible, balanced information while avoiding excessive online searching that can lead to worry. Preparing a list of specific questions for your doctor and talking openly about your concerns with a partner or friend can also alleviate the emotional burden.
Engaging in stress-reduction techniques can be beneficial during this period. Practices like mindfulness, meditation, or simple deep-breathing exercises can help calm the nervous system and reduce feelings of anxiety. Maintaining routines and engaging in hobbies can also provide a welcome distraction from the wait.
If you receive an elevated result, try not to panic. It is important to recall the numerous benign factors that can raise PSA levels. The most constructive action is to schedule a follow-up appointment with your doctor to discuss the results in context, considering your personal health history, age, and other risk factors.
The Follow-Up Process for an Elevated Result
A high PSA reading is the beginning of a diagnostic process, as a single elevated test is rarely used to make a definitive conclusion. The first step a doctor will likely take is to recommend a repeat PSA test after a few weeks. This helps confirm if the initial reading was accurate or a temporary fluctuation caused by a benign factor.
If the repeat test still shows a high level, your doctor may suggest additional tests to gather more information. One common option is a “free PSA” test, which measures the ratio of unattached (“free”) to attached PSA in the blood. A lower percentage of free PSA may be associated with a higher probability of prostate cancer, providing a more detailed risk assessment.
Your healthcare provider might also recommend imaging tests to get a direct look at the prostate gland. A prostate MRI (magnetic resonance imaging) is a non-invasive procedure that uses magnetic fields to create detailed images of the tissue. An MRI can help detect suspicious areas and identify other conditions like BPH, which is valuable in deciding if a more invasive procedure is warranted.
Based on the combination of these results, you may be referred to a urologist, a specialist in urinary and male reproductive system health. The urologist will review all your test results and may perform their own examinations. Ultimately, they will discuss the possibility of a prostate biopsy, a procedure where small tissue samples are taken from the prostate for analysis.