My PSA is elevated. Now What Should I Do?

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By Shalin Shah, M.D. and John Papadopoulos, M.D. MD Anderson Regional Care Centers in Sugar Land and Katy

Bluecuretweetup.jpgThere has been a great deal of discussion in the news, at medical meetings, within advocacy groups and among men for some time now about the Prostate Specific Antigen (PSA) test for prostate cancer screening. No doubt this has sparked questions for men who want to do everything they can to monitor their health and stay on track with their cancer screening program.

MD Anderson recommends that men talk to their physicians about their risks for the disease or any symptoms they may be experiencing. Age, race and family history are factors that contribute to a man's risk and they should drive the conversation about whether a PSA test may be beneficial. Make sure your doctor takes the time to explain all aspects of screening.

So how do I know if I have prostate cancer?

If you have discussed the risks and benefits of screening for prostate cancer with your doctor and determined that you wish to be tested, what happens if your PSA comes back abnormal?

An elevated PSA does not necessarily mean that you have prostate cancer. PSA information could signal an infection or other benign conditions, but it also can determine if you may have prostate cancer at its earliest, most treatable stage.

If your PSA or prostate exam points to the possibility of cancer, you should ask to be referred to a urologist. A more in-depth discussion on the limitations and usefulness of PSA tests can then take place, along with a talk about your PSA history, overall health status and quality-of-life goals and preferences. 

You and your urologist should discuss the pros and cons of a prostate biopsy. The decision to proceed with a prostate biopsy will be up to you but you should learn all you can about the procedure so you can be comfortable with the decision to proceed.  If not, you may want to seek a second opinion.

What do I do if my biopsy shows that I have prostate cancer?

First, remain calm. A diagnosis of prostate cancer seldom means a rush to treatment.  Start gathering as much information as you can, educate and arm yourself with background about your diagnosis. The Internet has a lot of information, but be selective in your searches. Make sure the sites you read, visit and clip from are established and reputable sources for clinical information.
Reliable sites that we suggest:

  • - Check out MD Anderson's wide variety of articles, videos, resources, research stories about clinical trials, treatment options, screening guidelines.
  • - The National Cancer Institute site provides information that ranges from simple background to more complicated explanations of the disease and treatment.
  • The American Cancer Society offers information on the disease as well as community support programs.
Multidisciplinary Care
Not every instance of prostate cancer requires treatment.  We suggest you seek the expertise from a team of urologists, radiation specialists and medical oncologists who will focus on all aspects of your prostate cancer care.

Look for a team that can provide you an accurate diagnosis, stage of the disease and appropriate treatment options. You should also ask your team about managing the side effects of cancer and treatment, and looking ahead to life after cancer treatment.

Because many early cancers do not require upfront treatment, an organized, active surveillance program is one component of a quality prostate cancer program. Men with low-risk disease can be safely monitored and treated with surgery or radiation only if the cancer grows or progresses. A big part of this strategy also includes continuing education and support for men living with prostate cancer so that they can have the best quality of life.

Most importantly, your treatment team should take the time to know you and your goals and preferences. You should be encouraged to ask questions to obtain the information that you need to make the best possible choices and decisions in your care. 

June is Men's Health Awareness Month, and in observance, we would encourage two key actions for all men:  Be proactive and learn more about prostate cancer.  Then, take time to learn about prevention, and the healthy changes you can make to your lifestyle to protect yourself.


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