prostate cancer

A raised PSA level is one of the most common reasons men are referred for prostate assessment. PSA testing is widely used to help monitor prostate health, particularly as men get older. While a raised result can be worrying, it is important to understand that PSA levels can increase for several reasons and do not always indicate prostate cancer. As men age, changes in the prostate are widespread. Both benign (non-cancerous) conditions and normal prostate enlargement can lead to higher PSA levels. For this reason, a raised PSA is best viewed as a signal for further evaluation rather than a diagnosis in itself. Let’s know more about what is raised PSA? What is PSA? Prostate-specific antigen (PSA) is a protein produced by the prostate gland. Small amounts of PSA enter the bloodstream and can be measured with a blood test to help assess prostate health. PSA levels often increase with age, but a raised PSA does not always mean prostate cancer. Risk factors for prostate cancer include family history, Black African or Black Caribbean ancestry, BRCA gene mutations, and obesity. Further assessment may be needed to determine the cause of an elevated PSA level. Also read more about Prostate cancer What is Raised PSA A raised PSA level can be worrying, but it is important to understand that PSA is not a cancer test itself. PSA levels can rise for many reasons, including age-related prostate enlargement and inflammation. Doctors take a look at the overall picture rather than a single number when deciding whether further tests are needed. What is a dangerous PSA level? While these ranges provide guidance, PSA trends are often more important than one isolated reading. A PSA that continues to rise over time or increases rapidly may be more significant than a stable PSA, even if the number itself is not very high. For this reason, doctors often repeat the test and may recommend additional investigations such as prostate MRI, free PSA testing, or a biopsy to understand the underlying cause. What causes raised PSA levels? There are several reasons for raised PSA levels causes, and in many cases, the cause is completely benign. A higher PSA does not automatically mean prostate cancer, which is why doctors look at possible underlying factors before recommending further tests. As the prostate increases in size, most commonly due to a benign condition called Benign Prostatic Hyperplasia (BPH), it tends to release more PSA into the bloodstream. In men with a significantly enlarged prostate, higher PSA levels are often expected. If an MRI scan shows an enlarged prostate with no suspicious features for cancer, PSA density (the amount of PSA relative to prostate size) can be calculated. This often explains the raised PSA and can be reassuring. PSA levels can also rise due to inflammation within the prostate. This may be linked to a current or past infection, such as prostatitis, or irritation caused by recent urinary procedures like catheterisation. These are common, non-cancerous reasons for raised PSA levels. In some cases, physical factors such as trauma or prolonged cycling can cause a temporary increase in PSA, which usually settles over time. An elevated PSA level may prompt further evaluation to determine whether prostate cancer is present. Prostate cancer can vary significantly, ranging from slow-growing forms that may never cause symptoms to more aggressive cancers that require timely treatment. Changes in urination, such as going more often or having a weaker stream, can be an early sign and should be discussed with a doctor. Most urinary problems are caused by non-cancerous conditions that are treatable, and early assessment ensures the right care. What are the raised PSA symptoms? A raised PSA itself does not usually cause noticeable symptoms. Often, it is discovered through a routine blood test before any problems are felt. In many cases, a slightly raised PSA is linked to benign prostate changes and may not cause symptoms at all. Sometimes, an underlying prostate issue that raises PSA may cause changes in urination. Common signs include urinating more frequently, especially at night, a weaker urine flow, difficulty starting or stopping, or a feeling that the bladder is not fully empty. It is important to remember that these symptoms are often caused by non-cancerous conditions, such as an enlarged or inflamed prostate. However, if any changes in urination are persistent or concerning, it is always best to seek medical advice for proper assessment. How to diagnose raised PSA? Diagnosing a raised PSA usually begins with a simple blood test, but it does not stop there. A raised PSA on its own does not diagnose prostate cancer, which is why further assessment is often needed to understand the underlying cause and decide whether treatment is required. The diagnostic process commonly includes a PSA blood test, a digital rectal examination (DRE), imaging of the prostate using MRI, and, in some cases, a prostate biopsy. PSA test The PSA test measures the concentration of prostate-specific antigen in a blood sample to help assess prostate health. A higher-than-normal result may indicate a prostate condition, but it cannot determine the exact cause. The test involves taking a blood sample, which is analysed in a laboratory, and the results are reported as nanograms per millilitre (ng/mL). Because PSA can rise for several benign reasons, further tests are often recommended if levels are raised. Digital rectal examination (DRE) Alongside a PSA test, a digital rectal examination is commonly performed. During this examination, a consultant urologist gently inserts a gloved, lubricated finger into the rectum to feel the prostate. This allows them to assess the size, shape, and texture of the gland. Although it may feel uncomfortable, the examination is quick, painless and provides valuable clinical information. Prostate MRI scan If PSA levels are raised or the DRE is abnormal, a prostate MRI scan is usually advised. MRI scans are highly effective at identifying areas within the prostate that may be suspicious for cancer. If concerning areas are seen, the MRI helps guide whether a biopsy