What should you know about low PSA prostate cancer?

PSA is a substance made by prostate cells. A blood test measures it, but the result can be influenced by prostate enlargement, inflammation, medicines and cancer biology. Some prostate cancers release relatively little PSA, particularly when the cells have changed in a way that makes the usual marker less informative.

Clinicians may consider urinary symptoms, a rectal examination, the pattern of PSA over time, prostate imaging and tissue sampling. A low result is therefore one piece of information, not a clearance certificate. A prostate cancer diagnosis is based on evidence about cells and disease behaviour.

Keep the appointment arranged to review the result and explain why testing was requested. Bring a list of medicines, previous PSA results and any urinary or sexual symptoms. Depending on the findings, the next step may be repeat blood testing, magnetic resonance imaging or a biopsy. If cancer is confirmed, options can include monitoring, surgery or radiation-based treatment, chosen according to grade, stage, general health and personal priorities.

Read about [Prostate Cancer](/conditions/prostate-cancer/) and the treatment terms [Radiotherapy](/treatments/radiation-oncology/radiotherapy/) and [Prostate Removal Surgery](/treatments/surgical-oncology/prostatectomy/) before your consultation.

Contact your care team promptly for inability to pass urine, worsening blood in the urine, new severe bone or back pain, leg weakness or loss of bowel control. Difficulty passing urine needs medical assessment even though it can have causes other than cancer; see [Difficulty Passing Urine](/symptoms/difficulty-passing-urine/). Seek emergency help for sudden paralysis, severe weakness or inability to urinate.

Ask what the PSA result means in relation to your age, prostate size and previous results; whether examination or imaging is needed; what a biopsy would show; and how treatment would differ if the cancer produces little PSA. You can also ask whether [Brachytherapy](/treatments/radiation-oncology/brachytherapy/) or [Targeted Radioisotope Therapy](/treatments/radiation-oncology/targeted-radioisotope-therapy/) is relevant to your situation.