PSA, refers to prostate-specific antigen and is a protein produced by both normal and cancerous cells in the prostate gland. It is normal for all men to have detectable PSA levels in the blood, these levels can vary based on age, prostate size, and health conditions.

While prostate cancer is one potential cause of elevated PSA levels, several other conditions or factors can contribute:

• Benign Prostatic Hyperplasia (BPH): An enlargement of the prostate that typically occurs with age and can cause higher PSA levels without being linked to cancer.

• Prostatitis: An inflammation or infection of the prostate that often leads to a temporary spike in PSA levels.

• Recent Ejaculation: Sexual activity can temporarily elevate PSA levels.

• Prostate Stimulation: Activities such as cycling or medical procedures like a digital rectal exam or prostate biopsy can cause a temporary increase in PSA.

• Ageing: PSA levels naturally tend to rise as men age, even in the absence of underlying conditions.

• Urinary Tract Infection (UTI): UTIs can irritate the prostate, leading to increased PSA.

• Prostate Cancer: Although less common than other causes, prostate cancer can result in elevated PSA levels and warrants further investigation if suspected.

Understanding the underlying cause of elevated PSA levels often requires tailored medical evaluation and care. It’s important to note that elevated PSA levels do not automatically mean prostate cancer. PSA levels may rise for a variety of reasons, many of which are benign.

If your PSA levels are elevated, further investigations may be necessary to determine the cause and address any underlying issues. Some typical diagnostic steps include:

• Repeat PSA Testing: A second PSA test may be performed to confirm initial results and track any trends over time.

• Digital Rectal Examination (DRE): A doctor may perform a manual examination of the prostate to assess its size, texture, and any abnormalities.

• Prostate MRI: Magnetic resonance imaging can provide a detailed view of the prostate, helping to identify any areas of concern.

• Prostate Biopsy: If there’s a significant suspicion of cancer, a biopsy may be conducted to collect and analyse prostate tissue.

• Urine or Blood Tests: These can identify infections, inflammation, or other conditions contributing to elevated PSA.

It’s vital to approach PSA elevation with an open mind. Many men with elevated PSA levels do not have prostate cancer, and proper diagnostic steps can provide clarity and peace of mind.

The decision to undergo PSA testing is highly individual and depends on several factors, including age, family history, personal preferences, and overall health. For example, Australian guidelines recommend PSA testing as part of shared decision-making between men aged 50 to 69 and their healthcare providers, with earlier testing for those with a family history of prostate cancer.

Benefits of PSA Testing:

• Early detection of conditions such as prostate cancer allows for timely intervention.

• Identifies risks and guides personalised monitoring or treatment options.

Potential Drawbacks:

• Elevated PSA levels can lead to further testing, which may carry risks or cause stress.

• The PSA test alone cannot determine whether an elevated level is due to cancer or a benign condition, sometimes leading to unnecessary biopsies.

For Australian men, staying informed about prostate health is an essential part of overall wellbeing. Seeking a trusted healthcare provider who takes the time to understand your individual risks and needs can help you make an informed decision about PSA testing.