PSA level of 3.8 - should I be worried?

[mwb59]

Hello everyone, I'm a 61 year old chap from the Dorset area and wanted some experienced advice from the board. I had a PSA test done last week by my GP as I lost a good friend to prostate cancer last year and since I'm 'coming of age' I thought it prudent to get mine checked too.

I haven't had any trouble passing urine or any symptoms like that, but the PSA test came back at a level of 3.8 - which seems high - shouldn't it be zero? What does this mean - could I have prostate cancer and if so, what do I do next?

Appreciate any help. Thanks, Tony

[professoreden]

Tony, the age-adjusted upper limit of normal for a 60-year old man like you is 4.5 ng/ml, so your PSA is normal although it is at the higher end of the normal range. Your PSA won't be zero as you have a prostate, which makes PSA. In the absence of any urinary symptoms I would simply recommend that you have your PSA checked again in a year. For other readers, the permitted normal range for men in their 40s is 0-2.5 ng/ml and 50s is 0-3.5 ng/ml. From 60 years on it's 4.5 ng/ml.

[mwb59]

Tony, the age-adjusted upper limit of normal for a 60-year old man like you is 4.5 ng/ml, so your PSA is normal although it is at the higher end of the normal range. Your PSA won't be zero as you have a prostate, which makes PSA. In the absence of any urinary symptoms I would simply recommend that you have your PSA checked again in a year. For other readers, the permitted normal range for men in their 40s is 0-2.5 ng/ml and 50s is 0-3.5 ng/ml. From 60 years on it's 4.5 ng/ml.

Phew well that's a relief! Thank you. No doubt something to keep an eye on for the future though as I seem close to the upper end of the range. Is it possible for a PSA level to suddenly shoot up above the normal range or is it a much slower, 'gently rising' process? In other words, could my situation escalate quite quickly?

[professoreden]

Hi Tony. The two things that concern urologists about PSA levels are the absolute figure, i.e the level at any given time, and the trend in PSA values. About 20% of men with prostate cancer have a normal PSA level and many of them are diagnosed because their GP refers them for investigation of a rising PSA level. This is just as concerning as an elevated PSA level. We know that a number of things, apart from cancer, can elevate the PSA: increasing age, increasing size of prostate, prostate enlargement that obstructs the flow of urine from the bladder, a urinary tract infection, prostate trauma such as after a prostate biopsy or after a bumpy bike ride, bacterial infection of the prostate (prostatitis) and ejaculation. Large, sudden rises in PSA are usually due to one of these factors, however, and not to rapidly progressing prostate cancer as most prostate cancers are slow-growing.