What should you do if you got a High PSA blood test?

High PSA Topic
FB Dr Soarawee
Soarawee Weerasopone, MD

Minimally Invasive Uro-Oncologist
Royal Phnom Penh hospital, Kingdom of Cambodia

PSA or Prostate-specific antigen is one of the most common laboratory tests included in elderly male health checkup package. Lots of gentlemen who get an over-reference on PSA blood test will get more often to see me up at my office for counseling. In this topic, we’re going to discuss about what you should do when you got a High PSA value.

PSA blood test
PSA blood test is the most popular way for screening prostate cancer.

In the meantime, normal definite of High PSA is more than 4 ng/mL, and I need to let you know that a High PSA absolutely doesn’t mean you’re 100% prostate cancer. While PSA represents everything related to the prostate tissue, so anything that stimulated the prostate it is resulting in a rising PSA value.

Here are common pitfalls of High PSA.

  • Recently having sexual activity – Several literatures confirmed that ejaculation just within 24 hours before blood test significantly showing an increasing of the PSA value.
  • Recently doing a heavy exercise – An hour of bicycling or jogging can rise up the PSA value, but it will turn back to a normal value within 48 hours.
Recent SI
Recent sexual activity can result in elevated PSA value.
Recent long distance bicycling can be another caused in PSA elevation.

If prostate cancer still suspected, counseling very carefully with patients very suggested to, because the only way to confirm the diagnosis is the Transrectal Ultrasound-guided biopsy (TRUS Biopsy) which is very harmfully. But I will try every single way to avoid unnecessary biopsy by doing these few methods.

  • PSA Velocity – Serial PSA blood tests can prospect on how the possibly prostate cancer is, with rising greater than 0.75 ng/mL in one year suggests potential cancer.
  • Free PSA and Total PSA – Normally there are 2 types of PSA circulating in blood stream, Free PSA and Total PSA. In prostate cancer situation, a Free PSA is relatively low in blood stream, with Free PSA less than 10%, the risk of cancer will be around 50% chance.
  • MRI prostate – MRI is becoming a standard imaging modality for prostate cancer diagnosis. There’re confirmed literatures showing more than 90% cancer detection rate on MRI prostate.
MRI Prostate is a promising modality for avoiding unnecessary prostate biopsy.

The essential message we should giving to the patient is, the prostate cancer is usually a non-aggressive in natural history and we will try in every way to minimize unnecessary harmful biopsy. Anyway, once the biopsy is necessary, do not hesitate to tell patients when they really need to do. Any questions, you can discuss with your trusted Urologist and it would be my honor if you text me. Be safe from prostate cancer!

In case, you are questioned that you should go on Prostate cancer screening program or not? Please visit this link.

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2 thoughts on “What should you do if you got a High PSA blood test?

  1. Thank you doc. It is always very informative to read your articles. Have a great day!

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