Understanding the PSA Blood Test
As men get older, many begin to ask about prostate health and whether they should have a PSA blood test. In my practice, I explain that the Prostate-Specific Antigen (PSA) test can provide valuable information about the prostate, but it cannot diagnose prostate cancer on its own.
PSA is one part of a broader assessment that includes your symptoms, medical history, physical examination and, when appropriate, additional investigations.
What Is PSA?
PSA is a protein produced by the prostate gland. Small amounts normally circulate in the bloodstream, and the PSA blood test measures its level.
Higher-than-normal PSA levels may indicate changes affecting the prostate, but they do not necessarily mean cancer is present.
Why Might Your Doctor Recommend a PSA Test?
Your doctor may recommend a PSA test if you:
- Have urinary symptoms
- Have a family history of prostate cancer
- Have an enlarged prostate
- Are monitoring prostate health after treatment
- Wish to discuss prostate cancer screening based on your age and individual risk factors
The decision to perform PSA testing should be made after discussing its potential benefits and limitations with your doctor.
What Can Cause an Elevated PSA?
An elevated PSA level may be caused by:
- Prostate cancer
- Benign Prostatic Hyperplasia (BPH)
- Prostatitis (inflammation or infection of the prostate)
- Recent urinary tract infection
- Recent prostate procedures or catheterisation
- Increasing age
Because many non-cancerous conditions can raise PSA levels, further assessment is often required.
Can PSA Diagnose Prostate Cancer?
No.
A PSA test alone cannot confirm or exclude prostate cancer. Some men with prostate cancer have normal PSA levels, while many men with elevated PSA levels do not have cancer.
If your PSA result is abnormal, your doctor may recommend repeat testing, imaging such as a prostate MRI, or referral to a urologist for further evaluation.
When Should You Consider PSA Testing?
You may wish to discuss PSA testing with your doctor if you:
- Are aged 50 years or older
- Have a father or brother with prostate cancer
- Develop urinary symptoms such as difficulty passing urine, weak urine flow or frequent urination
- Have concerns about your prostate health
Your doctor will help determine whether PSA testing is appropriate based on your individual circumstances.
Doctor's Insight
In my practice, I encourage men to make informed decisions about PSA testing. While PSA can be a useful tool for assessing prostate health, it is not a definitive test for cancer. Understanding the benefits, limitations and possible next steps allows patients to make choices that are right for them.
– Dr. Teh Boon Teong
Consultant in Internal Medicine
Evercare Medical Care Centre, Penang, Malaysia.
Frequently Asked Questions
It measures the level of Prostate-Specific Antigen, a protein produced by the prostate gland.
No. PSA alone cannot diagnose prostate cancer and should be interpreted alongside other clinical findings.
Elevated PSA may occur with prostate cancer, benign prostate enlargement, prostatitis, urinary tract infections or recent prostate procedures.
The decision should be based on your age, symptoms, family history and a discussion with your doctor about the benefits and limitations of testing.
Your doctor may recommend repeat testing, imaging such as an MRI, or referral to a urologist for further assessment.