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Normal PSA Levels and You

What are normal PSA levels?

Does an elevated level mean a dramatically greater risk of cancer?

What causes high amounts of this antigen to be in your blood? Is this abnormal?

These are great questions. It's good to see you are thinking in the right direction. Let's see if we can help with some answers, okay?

For starters the prostate gland produces a substance called PSA which is short for Prostate Specific Antigen. This enzyme is found in small amounts in your bloodstream and semen.

An infection, tumor or other problems with this gland can cause the amount of this enzyme to rise. Typically the PSA test measures how much of this there is in your blood since elevated levels are a potential sign of cancer.

PSA is measured in nanograms per millimeter of blood. It's felt that scores under 4 nanograms represent normal PAS levels. While 4 ng/ml to 10 ng/ml means there is likely a 25% chances of cancer. Higher than that signals a 50% chances of prostate cancer.

But finding a higher than expected amount of PSA does not necessarily signal you have cancer. Age, inflammation of your prostate, enlargement of your prostate and such can all contribute to a rising level of PSA. So readings above an upper limit of 4 does not mean you will succumb to cancer.

On the other hand 15% of people who are diagnosed with cancer have a normal or lower PSA report. So such testing coupled with digital rectal examination (DRE) annually can give important clues about what's going on with your prostate.

Besides, like I mentioned, there are other factors to take into consideration when deciding if a rising level is too high.

Age adjustment is one of them. If you are between 40 and 80 years old then what's normal may be adjusted to 2.4 ng/ml higher or lower.

PSA velocity is another important factor. That is - the rate of change seen over a period of time. If your PSA is less than 2 but if it increases 0.35 to 0.5 ng in a year's time then you may be at increased risk for cancer. While numbers greater than 4 increasing faster than .75 ng per year also call for further review.

But again you need to take these for what they are. Indicators. The only way to tell for sure about cancer is with a biopsy. Usually performed after a higher than expected PSA reading is registered.

Another factor is PSA density which is actually PSA divided by PSA volume. If you have higher density then you are more likely to have tumorous growth.

The last factor is percent free PSA (PSA-f) which is the ratio of free PSA to bound PSA in the total PSA found in the blood sample. Free PSA means it is not bound to any protein in the blood. A 25% of PSA-f in the blood can signal BPH and less than 15% of PSA-f can signal cancer. So a free PSA test can rule out if you have cancer.

Now if you have an elevated level, typically the next step would be to get repeat test.

If that comes back on the high side you might expect to take a course of antibiotics to deal with any possible prostate inflammation.

If that doesn't help a biopsy will be ordered.

Bottom line? There is no need to panic if you are found to have a high PSA number. The level can vary up to 20% in a day. And as much as we'd like a magic number that signals definite problems there is none. It's only by analyzing a variety of factors can hard conclusions be drawn.