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𝘛𝘩𝘳𝘰𝘶𝘨𝘩𝘰𝘶𝘵 𝘚𝘦𝘱𝘵𝘦𝘮𝘣𝘦𝘳, 𝘛𝘩𝘦 𝘗𝘦𝘰𝘱𝘭𝘦’𝘴 𝘛𝘳𝘪𝘣𝘶𝘯𝘦 𝘸𝘪𝘭𝘭 𝘱𝘭𝘢𝘤𝘦 𝘢 𝘴𝘵𝘳𝘰𝘯𝘨 𝘧𝘰𝘤𝘶𝘴 𝘰𝘯 𝘱𝘳𝘰𝘴𝘵𝘢𝘵𝘦 𝘤𝘢𝘯𝘤𝘦𝘳 𝘢𝘴 𝘱𝘢𝘳𝘵 𝘰𝘧 𝘗𝘳𝘰𝘴𝘵𝘢𝘵𝘦 𝘊𝘢𝘯𝘤𝘦𝘳 𝘈𝘸𝘢𝘳𝘦𝘯𝘦𝘴𝘴 𝘔𝘰𝘯𝘵𝘩, 𝘸𝘪𝘵𝘩 𝘢 𝘴𝘦𝘳𝘪𝘦𝘴 𝘢𝘪𝘮𝘦𝘥 𝘢𝘵 𝘦𝘯𝘤𝘰𝘶𝘳𝘢𝘨𝘪𝘯𝘨 𝘮𝘦𝘯 𝘪𝘯 𝘚𝘵. 𝘔𝘢𝘢𝘳𝘵𝘦𝘯 𝘵𝘰 𝘭𝘦𝘢𝘳𝘯 𝘮𝘰𝘳𝘦 𝘢𝘣𝘰𝘶𝘵 𝘵𝘩𝘦𝘪𝘳 𝘱𝘳𝘰𝘴𝘵𝘢𝘵𝘦 𝘩𝘦𝘢𝘭𝘵𝘩, 𝘶𝘯𝘥𝘦𝘳𝘴𝘵𝘢𝘯𝘥 𝘵𝘩𝘦𝘪𝘳 𝘳𝘪𝘴𝘬𝘴 𝘢𝘯𝘥 𝘣𝘦𝘤𝘰𝘮𝘦 𝘮𝘰𝘳𝘦 𝘤𝘰𝘮𝘧𝘰𝘳𝘵𝘢𝘣𝘭𝘦 𝘩𝘢𝘷𝘪𝘯𝘨 𝘤𝘰𝘯𝘷𝘦𝘳𝘴𝘢𝘵𝘪𝘰𝘯𝘴 𝘢𝘣𝘰𝘶𝘵 𝘵𝘦𝘴𝘵𝘪𝘯𝘨 𝘢𝘯𝘥 𝘦𝘢𝘳𝘭𝘺 𝘥𝘦𝘵𝘦𝘤𝘵𝘪𝘰𝘯.
In the first installment of The People’s Tribune’s Prostate Cancer Awareness Series, we looked at the possible warning signs of prostate cancer and an important reality, early prostate cancer often causes no symptoms at all. That leads naturally to one of the most common tools used to investigate prostate health, the PSA blood test.
For many men, however, getting the test is the easy part. Understanding the number that comes back can be much more confusing. Is 2 good? Is 4 bad? Does a PSA of 7 mean cancer? And at what point should a man become concerned?
The first thing to understand is that there is no single PSA number that can tell a man whether he has or does not have prostate cancer. PSA, or prostate-specific antigen, is a protein produced by prostate cells. The test measures how much of it is present in the blood, usually expressed as nanograms per milliliter, or ng/mL.
What is considered normal?
Historically, a PSA below 4 ng/mL was often considered normal and anything above 4 prompted closer attention. Today, doctors know it is not that simple.
Many doctors still use 4 ng/mL as an important reference point, while others may begin looking more closely at levels of 2.5 or 3, particularly in younger or higher-risk men. Age can also be taken into account because PSA levels tend to rise as men get older.
Most men without prostate cancer have a PSA below 4. But a PSA below 4 does not guarantee that cancer is absent. The American Cancer Society notes that about 15 percent of men with PSA levels below 4 who undergo a biopsy are found to have prostate cancer.
This is why a doctor should interpret the result rather than a man simply comparing his number with something he found online.
What about PSA between 4 and 10?
Doctors sometimes describe PSA levels between 4 and 10 ng/mL as the borderline range. According to the American Cancer Society, men within this range have roughly a one in four chance of having prostate cancer. Once PSA rises above 10, the likelihood of prostate cancer is greater than 50 percent.
Those figures are important, but they also show why an elevated PSA is not a cancer diagnosis. Even among men with PSA between 4 and 10, most will not ultimately be diagnosed with prostate cancer.
The number is a signal that deserves further evaluation, not a verdict.
Plenty of things can raise PSA
Cancer is only one reason PSA can rise. Benign prostatic hyperplasia, or BPH, which is the non-cancerous enlargement of the prostate that becomes common with age, can increase PSA. Prostatitis, which is inflammation or infection of the prostate, can also cause an increase.
Recent ejaculation and vigorous exercise, particularly cycling, can temporarily influence PSA. Procedures involving the prostate can raise it as well. The National Cancer Institute advises that activities capable of temporarily raising PSA may need to be avoided for about two days before testing.
Certain medications can have the opposite effect. Drugs such as finasteride and dutasteride, which are commonly used to treat an enlarged prostate, can lower PSA. A doctor therefore needs to know what medications a patient is taking when interpreting the result.
One number is not always the whole story
An unexpectedly elevated PSA may lead to another PSA test rather than immediately to a biopsy. The National Cancer Institute notes that a doctor may recommend repeating the test in approximately six to eight weeks to determine whether the elevation persists.
Doctors may also consider previous PSA results, age, family history, prostate examination findings and other risk factors. Additional blood or urine tests can sometimes help estimate risk, while an MRI can be used to look for suspicious areas in the prostate before deciding whether a biopsy is necessary.
Ultimately, a PSA test cannot confirm prostate cancer. If the findings remain concerning, a biopsy, in which samples of prostate tissue are examined under a microscope, is used to determine whether cancer cells are present.
When should you start asking about PSA?
There is no one screening schedule for every man. The American Cancer Society recommends discussing prostate cancer screening with a healthcare provider from age 50 for men at average risk. It recommends beginning that conversation at 45 for Black men and men with a father or brother diagnosed before age 65, and at 40 for men with more than one close relative diagnosed at an early age.
For men in St. Maarten, particularly Black men and those with a family history of the disease, that conversation matters.
The takeaway from your PSA result should therefore not simply be, “Is my number above four?” The better questions are: What does this number mean for me? Has it changed? What could be affecting it? And based on my age, history and risk, do I need further testing?
A high PSA deserves attention, not panic. A low PSA should not create false confidence. What matters most is understanding the result with your doctor and deciding what, if anything, should happen next.
Click here for more awareness via our previous previous coverage:
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