What Is PSA?
PSA stands for prostate-specific antigen, a protein produced by the prostate gland. The prostate is a small gland located below the bladder.
A PSA blood test measures the amount of this protein circulating in your blood.
PSA is often called a tumor marker because its concentration can increase in prostate cancer. However, PSA is not specific to cancer. Normal prostate tissue also produces it.
Why Can PSA Levels Be Elevated?
A higher PSA level does not automatically mean prostate cancer.
Several conditions can increase PSA, including:
- Benign enlargement of the prostate, which becomes more common with age.
- Inflammation or infection of the prostate.
- Recent urinary procedures.
- Prostate cancer.
Ejaculation and vigorous cycling may also temporarily influence PSA levels.
Certain medications, including finasteride and dutasteride, can lower PSA concentrations. Your doctor should know if you take them.
What Is a Normal PSA Level?
There is no single PSA value that reliably separates a healthy prostate from prostate cancer.
PSA levels often increase with age. Doctors consider your age, medical history, prostate size, and previous results when interpreting the test.
A relatively low PSA does not completely exclude cancer. Equally, an elevated PSA does not confirm it.
This is why one PSA result should never be interpreted in isolation.
What Is the Difference Between Total PSA and Free PSA?
Most routine PSA tests measure total PSA, which includes different forms of the protein in your blood.
Some PSA circulates independently. This is called free PSA.
In selected men with moderately elevated total PSA, the percentage of free PSA may help doctors decide whether additional investigations are necessary.
A lower percentage of free PSA can be associated with a greater likelihood of prostate cancer. However, it cannot establish a diagnosis.
Can PSA Help Detect Prostate Cancer Early?
Yes. PSA testing can help detect prostate cancer before symptoms develop.
However, not every prostate cancer becomes dangerous. Some grow very slowly and may never affect a person’s health.
Detecting these cancers can sometimes lead to unnecessary investigations or treatment.
For this reason, PSA screening decisions should consider age, family history, inherited risk, general health, and personal preferences.
What Happens If Your PSA Is Elevated?
A newly elevated PSA is often measured again before further investigations.
If the result remains concerning, your doctor may recommend additional assessment, including prostate magnetic resonance imaging (MRI) and, when appropriate, a biopsy.
The aim is to identify cancers that may require treatment while avoiding unnecessary procedures.
