Prostate-specific antigen, or PSA, is a protein associated with prostate health. For men in their mid-70s, understanding a “normal” PSA level involves considering several factors beyond a single number. This information helps individuals and their healthcare providers make informed decisions.
What is PSA
Prostate-specific antigen (PSA) is a protein produced primarily by the cells of the prostate gland, a small gland located below the bladder in men. Its main function involves liquefying semen, which helps sperm move more freely. Small amounts of PSA are normally present in the bloodstream. A PSA test is a simple blood test that measures the concentration of this protein in the blood.
Normal PSA Levels for a 75-Year-Old Man
For a 75-year-old man, a “normal” PSA level is not a fixed value but a range that varies. General guidelines suggest that for men aged 70 and above, a typical PSA level might be up to 5 ng/mL, though some sources extend this to 6.5 ng/mL. PSA levels naturally increase with age, even without prostate disease. Different medical guidelines and laboratories may have varying reference ranges, making individual interpretation with a doctor important. For instance, some studies indicate that the 95th percentile for men aged 75-79 could be around 7.95 ng/mL.
Factors Influencing PSA Levels
Several non-cancerous conditions and activities can cause PSA levels to rise. Benign prostatic hyperplasia (BPH), a common non-cancerous enlargement of the prostate, often leads to elevated PSA levels. Inflammation or infection of the prostate, known as prostatitis, can also increase PSA. Urinary tract infections (UTIs) are another common cause for a temporary spike.
Recent ejaculation can temporarily elevate PSA levels, usually for 24 to 72 hours. A recent digital rectal exam (DRE) or other prostate stimulation, such as cycling, may also cause a temporary increase. Certain medical procedures or medications can affect PSA levels, either raising or lowering them.
Understanding Elevated PSA
An elevated PSA level does not automatically mean prostate cancer is present. Instead, it serves as a screening tool indicating a need for further investigation into prostate health. Many conditions can cause PSA to be higher than expected. A high PSA reading suggests a prostate issue but is not a definitive cancer diagnosis. Only a small percentage of men with elevated PSA levels are ultimately diagnosed with prostate cancer.
Next Steps After a PSA Test
If a PSA test shows an elevated level, the initial step often involves repeating the test to confirm the finding, as PSA levels can fluctuate. If the level remains elevated, consulting a urologist is recommended for a specialized assessment. The urologist may perform a digital rectal exam (DRE) to feel for prostate abnormalities.
Further diagnostic steps might include additional blood tests, such as a “free PSA” percentage, which can help differentiate between benign conditions and cancer. Imaging tests like a multiparametric MRI or transrectal ultrasound may also be used to visualize the prostate. If concerns persist, a prostate biopsy, which involves taking tissue samples for microscopic examination, is the only way to definitively diagnose prostate cancer. Decisions about these next steps should involve shared decision-making between the patient and doctor, considering individual health, life expectancy, and personal preferences.