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PSA Level Came Back Elevated? Now What?

How to Figure Out What the PSA Count Is Really Telling You

Nicholas Berrisford didn't have a warm fuzzy feeling when he heard his PSA level. "My PSA numbers had moved up from just under three to well over four with the latest PSA testing. Or well within the "biopsy-is called-for" territory. Which didn't exactly make me jump for joy, let me tell you."

"Even though I knew," Berrisford continued, "that a PSA count of greater than four only signals cancer for about one out of four men, I'd rather not have to face the uncertainty of it all. Know what I mean?"

As Nick pointed out, it's well known that the PSA test is far from a perfect indicator of cancer. There are several reasons why your PSA level could be elevated. Cancer being but one.

So refinements have been made in the PSA testing process since it's introduction as one of the primary prostate cancer detection tools.

The first was the addition of the PSA density test, which compares the amount of PSA to the density of your prostate as determined through ultra sound.

Then came PSA velocity, or the rate of change from year to year, as another indicator. Or how fast the amount of prostate specific antigen is increasing.

The next refinement involved measuring free PSA. Which looks at the percentage of PSA not bound in the blood. Here a low level of free PSA is a strong indicator of cancer.