Types of PSA tests

Total PSA measures the amount of prostate-specific antigen in the blood. Free PSA measures the portion not attached to blood proteins; comparing free and total PSA may help when the total result is in an uncertain range. PSA density relates the result to prostate size, while PSA velocity describes change across tests over time. These measures support clinical judgement rather than replacing it.

PSA can rise for reasons other than cancer, including benign prostate enlargement, inflammation, infection or recent procedures. Medicines can also change the result. A single reading therefore needs context, including age, prostate size, symptoms, examination and previous results.

Before a PSA Test, tell the clinician about medicines, urinary symptoms, infection and recent prostate procedures. If the result is unexpected, the next step may be a repeat test after an appropriate interval, examination, urine assessment or referral. An MRI Scan can help assess areas of concern, but imaging and PSA findings may still need a biopsy for diagnosis.

Contact a clinician about a new or changing urinary problem, blood in urine or semen, pelvic discomfort, or a PSA result you have been asked to discuss. Seek urgent care if you cannot pass urine, develop fever with urinary symptoms, or become seriously unwell after a prostate procedure. Urgency depends on symptoms, not on a PSA number alone.

Ask which PSA measurement was performed, how it compares with your earlier results, and whether prostate size, medicines or infection could affect it. Ask whether repeating the test, having an MRI Scan or seeing a specialist is appropriate, and what each possible next step would involve.