Raised PSA and prostate cancer

PSA is a protein made by prostate cells. The result may be influenced by prostate enlargement, inflammation, infection, recent procedures, ejaculation, medicines, and changes between tests. Clinicians consider the result alongside age, symptoms, examination findings, previous PSA results, family history, and overall health.

A raised PSA can be a presentation of prostate cancer, but many men with a raised result do not have cancer. Further assessment may include a repeat test, urine evaluation, imaging, or a biopsy. Difficulty passing urine can happen with prostate enlargement or other conditions and deserves assessment without assuming its cause.

Ask the clinician who arranged the test what the result means in your situation and when it should be repeated. Mention urinary symptoms, infection symptoms, medicines, recent procedures, and close relatives with prostate cancer. Do not start, stop, or change treatment based on one result.

If cancer is found, choices depend on its grade, extent, symptoms, and your preferences. Discussions may include active monitoring, prostate removal surgery, radiotherapy, brachytherapy, or other treatments such as targeted radioisotope therapy. Bone-strengthening therapy may be considered when cancer affects bone health.

Arrange follow-up for a raised PSA even if you feel well. Seek prompt medical care for inability to pass urine, fever with urinary symptoms, blood in urine, new persistent bone pain, unexplained weight loss, or worsening weakness. Sudden leg weakness, loss of bladder or bowel control, or severe back pain needs urgent assessment.

Ask what may have affected the test, whether it should be repeated, and whether examination, imaging, or biopsy is appropriate. If cancer is diagnosed, ask how far it has spread, what each treatment aims to do, and how surgery, radiotherapy, or robotic cancer surgery could affect urinary and sexual function.