Understanding the PSA Test and Normal Levels for Men

Prostate-Specific Antigen (PSA) is a protein produced by prostate cells, a small gland located just below the bladder. PSA circulates throughout the body in low levels at all times. Additionally, normal PSA levels vary depending on age. High PSA levels can indicate diseases such as prostate cancer or urinary infections. To determine PSA levels, a PSA test is necessary.

Understanding the PSA Test and Its Levels

A PSA test is performed to measure PSA levels in a man’s blood. It is highly sensitive and can detect elevated PSA levels above the average range. High PSA levels are associated with prostate cancer even before physical symptoms appear. However, elevated PSA levels can also indicate non-cancerous conditions, such as urinary infections.

It is important to note that a PSA test alone does not provide enough information for a doctor to make a diagnosis. However, doctors can consider PSA test results when determining whether symptoms and test findings are due to cancer or another condition.

So, what are normal PSA levels, and what is considered high?

Normal PSA Levels

Doctors typically categorize PSA levels as “elevated” or “not elevated” rather than “normal” or “abnormal” because PSA levels vary depending on age.

Technically, a person with any PSA level can develop prostate cancer, as PSA levels are not the only factor doctors consider when diagnosing the disease.

In general, PSA levels for men by age group are as follows:

Age 60 and older: < 4.0 mg/mL
Age 59 and younger: < 2.5 mg/mL

The average PSA level for younger men is typically < 1.0 mg/mL.

High PSA Levels

There is no absolute upper limit for PSA levels, as they can reach tens or even hundreds of thousands. However, general ranges of PSA elevation are:

4–10: Slightly elevated
11–20: Moderately elevated
21+: Very high

Doctors may examine patients with elevated PSA levels based on their age to determine the cause of the increase.

Factors That Affect PSA Levels

Aside from cancer, PSA levels in the blood can be influenced by several factors, including:

Ejaculation within the past 48 hours
Undergoing a prostate exam (digital rectal exam) before the PSA test
Intense exercise within the past 48 hours
Having a prostate biopsy within the past 6 weeks

There are specific guidelines on how long to wait between these activities and taking a PSA test. Therefore, it is advisable to consult a doctor before undergoing the test.

What Happens if PSA Levels Are High?

If PSA levels are high, the doctor may request additional tests to compare the results and confirm whether the PSA level is consistently elevated. If two PSA tests indicate high levels, the doctor may perform a digital rectal exam (DRE) to check the prostate gland for lumps or abnormal tissue.

If no abnormal tissue or growth is found, the doctor may choose to observe the patient for a few months to see if any other symptoms develop, followed by a follow-up test.

If the doctor detects an irregular growth, imaging tests such as prostate ultrasound or magnetic resonance imaging (MRI) may be ordered to obtain a detailed picture of the prostate and surrounding areas.

In some cases, a prostate biopsy (tissue sample) may be performed to examine the prostate tissue and determine the presence of cancer cells.

Imaging tests and biopsies help doctors confirm a prostate cancer diagnosis. These tests, along with PSA levels, also assist in determining the stage of prostate cancer.

Rezum Therapy for High PSA Levels Due to Benign Prostatic Hyperplasia

As mentioned earlier, elevated PSA levels are not always caused by prostate cancer. Benign Prostatic Hyperplasia (BPH), or prostate enlargement, can also lead to increased PSA levels. If this is the case, the doctor may recommend Rezum Water Vapor Therapy as a treatment.

Rezum therapy is a non-surgical treatment that uses natural energy in steam to eliminate excess prostate tissue pressing on the urethra.

This therapy offers several advantages over conventional BPH treatments, such as:

Safe and effective procedure with long-term results
Eliminates the need for BPH medication
Symptom improvement can be felt within a few weeks
Does not affect sexual function, including erection and ejaculation
Outpatient procedure (patients can go home the same day)
No general anesthesia required
Fast recovery time
Can be repeated if BPH symptoms return

If you are interested in learning more or undergoing Rezum Water Vapor Therapy, visit Mandaya Puri Hospital. Our Urology Center is equipped with advanced medical technology and a team of urology specialists ready to assist with all your concerns.

1. dr. Hendy Mirza, Sp.U(K)