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CancerQuest > Introduction to Patient Information > Introduction to Cancer Detection and Diagnosis > Prostate Cancer Detection: Prostate Specific Antigen (PSA) > PSA Test Results and New Developments

PSA Test Results and New Developments

Understanding the Results

It is important to understand exactly what an elevated PSA means. An elevated PSA level may indicate a higher risk of prostate cancer, but roughly half of all men with PSA levels higher than 10 ng/ml do not have cancer. Importantly, between 30% and 55% of men with early-stage prostate cancer will not have elevated PSA levels.⁽¹⁾

A digital rectal exam along with a PSA test can help a doctor assess the prostate further, but it still may not be enough to diagnose cancer. A physician may schedule a biopsy following an elevated PSA level along with a suspicious digital rectal exam. A biopsy is the removal of a small sample of the prostate for microscopic examination. Biopsy is the only way to confidently diagnose prostate cancer.

New Technologies

Newer technologies are being employed in an effort to make the PSA level test more accurate. Scientists are testing whether a specific form of PSA, called free-PSA, is better at predicting the presence of cancer than total PSA.⁽²⁾ In 1998, the FDA approved the use of free-PSA to help better-diagnose men with PSA levels between 4 and 10 ng/ml (the "grey zone"). In general, lower levels of free-PSA are associated with an increased possibility of having cancer. While the free-PSA test can make the regular PSA test more specific, it is still not perfect. Other techniques visualize the prostate using ultrasound, and use this information to supplement the PSA test. Finally, some scientists believe that the rate at which PSA levels increase may be useful in distinguishing prostate cancer from other changes in the prostate.⁽³⁾ These techniques are currently being evaluated.

References for this page:

1. "PSA." Web MD. [http://www.afud.org/conditions/psa.html]
2. The Doctor's Doctor [http://www.thedoctorsdoctor.com/labtests/prostate_specific_antigen.htm]
3. American Foundation for Urological Disease [http://www.afud.org/conditions/psa.html]