Prostate-specific antigen (PSA) is a protein produced by cells within the prostate gland, a small organ located below the bladder in men. This protein circulates in the bloodstream, and its levels are commonly measured to monitor prostate health. Understanding typical PSA levels, particularly for men around 65, is important for interpreting these test results.
What is PSA?
Prostate-specific antigen is a protein produced by both healthy and cancerous cells in the prostate gland. While most PSA remains in the seminal fluid, a small amount naturally enters the bloodstream. A blood test measures this circulating level of PSA. Although elevated PSA levels can be associated with prostate cancer, the presence of PSA in the blood is not exclusive to malignancy. Other conditions affecting the prostate can also lead to increased PSA levels.
Normal PSA Ranges for 65-Year-Old Men
Defining a “normal” PSA level is not a single number, as these levels can vary based on an individual’s age. For men aged 60 or older, a PSA level at or below 4.0 nanograms per milliliter (ng/mL) is often considered a general guideline. Some sources suggest that for men in the 60-69 age bracket, a range up to 4.5 ng/mL might be typical, though levels above 4.0 ng/mL usually prompt further investigation. PSA levels naturally tend to increase with age, partly due to the benign growth of prostate tissue.
For a 65-year-old man, while 4.0 ng/mL is a common threshold, these figures serve as general guidelines rather than definitive diagnostic cutoffs. A healthcare professional considers individual factors, including age, results from a digital rectal exam, and family medical history, when evaluating PSA test results.
Factors That Affect PSA Levels
Several non-cancerous conditions and activities can influence prostate-specific antigen levels, leading to readings outside typical ranges.
Common Factors Affecting PSA Levels
Benign prostatic hyperplasia (BPH): A common enlargement of the prostate gland in older men, which causes the prostate to produce more PSA.
Prostate inflammation or infection (prostatitis): Can also elevate PSA as the inflammation allows more PSA to enter the bloodstream. Prostatitis can present with symptoms such as painful urination or pelvic discomfort.
Recent ejaculation: Can temporarily increase PSA levels, with effects potentially lasting up to 48 hours. It is often recommended to abstain from ejaculation for two days before a PSA test.
Medical procedures: Urinary tract procedures, such as catheterization, cystoscopy, or a prostate biopsy, are known to significantly elevate PSA levels. These procedural elevations usually normalize within a few days or weeks.
Interpreting PSA Results and Next Steps
An elevated PSA level does not automatically mean prostate cancer. Instead, it indicates a need for further evaluation to determine the underlying cause. A healthcare provider will consider the PSA result in conjunction with other relevant information, such as the individual’s age, findings from a digital rectal exam, and any family history of prostate cancer.
Engaging in shared decision-making with a doctor is important to discuss the potential benefits and risks of subsequent steps. Follow-up actions might include repeating the PSA test, especially if factors like a recent infection or ejaculation could have influenced the initial result. Additional assessments may involve a digital rectal exam to physically check for prostate abnormalities.
Imaging tests, such as a prostate MRI, can offer more detailed views of the prostate and help guide any necessary biopsies. A prostate biopsy remains the only definitive method to diagnose prostate cancer. The PSA test functions as a screening tool, not a diagnostic one, making a comprehensive evaluation crucial for understanding an elevated reading.