What Causes a Raised PSA?

PSA, or prostate-specific antigen, is made by prostate cells and can enter the blood for reasons other than cancer. One result cannot identify the cause by itself, so clinicians consider the level, any change over time, age, prostate symptoms, examination findings and medicines.

Benign prostatic enlargement can increase the amount of prostate tissue producing PSA. Prostatitis, a urinary infection or irritation can also raise the result, sometimes alongside burning urination, pelvic discomfort, fever or difficulty passing urine. Recent ejaculation, vigorous cycling, a catheter, or another procedure involving the urinary tract may temporarily affect PSA.

Prostate cancer is one possible explanation, but a raised PSA does not diagnose it and many raised results have a non-cancer cause. A clinician may repeat the test after a suitable interval, check for infection, review medicines such as finasteride, and examine the prostate. Further assessment may include an MRI scan and, when appropriate, a biopsy.

Arrange a review with the clinician who ordered the test. Tell them about urinary symptoms, fever, recent ejaculation, cycling, catheter use, prostate procedures and all medicines or supplements. Do not stop prescribed treatment without advice. Ask whether the test should be repeated and what preparation is needed; avoid strenuous activity or ejaculation beforehand only if your clinician advises it.

The next step depends on your overall picture rather than a single number. A repeat PSA may clarify whether the result remains raised. If concern persists, an MRI scan can provide images of the prostate, while a biopsy examines tissue when a definite diagnosis is needed.

Contact your clinician promptly if a raised PSA is accompanied by fever, chills, worsening pelvic pain, blood in the urine, or new difficulty urinating. Seek urgent medical help if you cannot pass urine, feel severely unwell, or develop confusion or marked weakness, because infection or urinary blockage may need rapid treatment.

A raised result without these symptoms still needs follow-up, but it is not usually an emergency. Keep the appointment so the result can be interpreted alongside your symptoms, examination and previous PSA results.

Useful questions include: Could infection, prostate enlargement or a recent procedure explain my result? Should the PSA be repeated, and when? Do any of my medicines change how the result is interpreted? Would an MRI scan help decide whether a biopsy is needed? What symptoms should prompt me to seek urgent help?