Does a High PSA Always Mean Cancer?
Q: I’m confused about the PSA screening. There’s been a lot of conflicting information in the news recently. Should I be getting a routine testing? And if my PSA levels are high, does it mean I have prostate cancer?
Pete K.
Dr. G: Listening to advice about whether or not to get a prostate-specific antigen (PSA) test is a lot like watching a game of tennis. It keeps going back and forth.
Get it.
Don’t get it.
Get it.
Don’t get it.
When the “experts” keep changing their minds, it’s no wonder you (and most other men) would be confused.
For years, the PSA test was the end-all, be-all of prostate testing. Doctors pushed the test on their patients, and the patients dutifully listened.
Then a few years ago, this golden child of cancer screening fell out of favor.
It turned out that high PSA levels don’t necessarily indicate that a man has prostate cancer. And having normal levels doesn’t mean you DON’T have cancer!
The fact is, there are numerous factors that could cause PSA levels to be high that have nothing to do with prostate cancer. These include:
- Prostatitis, a condition caused by an inflamed prostate
- BPH, which is an enlarged prostate
- Certain medical procedures, like having a urinary catheter
- Urinary tract infections
- Strenuous exercise shortly before the PSA
- Ejaculation within 48 hours of the PSA
Despite this long list of potential causes of high PSA levels (that don’t include prostate cancer), most men who have a high reading will be compelled to get a biopsy.
That might seem innocent enough, but these procedures are incredibly invasive and can come with some pretty hefty complications, like bleeding, urinary retention, and life-threatening infections.
Making the matter even more complicated, men who DO have prostate cancer can live long, healthy lives following the “active surveillance” approach, while the surgery to remove the cancer can leave men incontinent, impotent, and in misery.
So what’s the answer?
I now recommend a new test called the 4Kscore Test. This test uses a unique algorithm that calculates a patient’s risk for aggressive prostate cancer—and that is, after all, what you really want to know.
The test is incredibly accurate, with fewer than 2 percent of significant cancers being missed, and ZERO more aggressive cancers being missed.
If you have a high PSA reading, talk to your doctor about the getting 4Kscore before making any decisions.
Want me to answer your question next? Email me at [email protected]
To a brighter day,
Dr. Richard Gerhauser, M.D.
