If your PSA level is high

What happens next depends on:

• whether or not you have any symptoms
• how your prostate gland feels when examined using a digital rectal examination
• your personal risk of prostate cancer
• how high the PSA level is.

The older you are, the higher your PSA level is likely to be, whether or not you have prostate cancer. So what is ‘normal’ depends to some extent on your age:

• In men aged 50–59, a PSA level of 3 nanograms per millilitre (ng/ml) of blood or lower is considered normal.
• In men aged 60–69, a PSA level of 4ng/ml or lower is considered normal.
• In men aged 70 and over, a PSA level of about 5ng/ml is considered normal.

As the prostate glands of different men vary in size, this can also affect PSA levels. Men with larger prostate glands may have a higher PSA level.

Your options after a PSA test

As a guide, here are the three options you have after a PSA test:

• PSA normal You are unlikely to have cancer and no further action is needed.
• PSA slightly raised You probably do not have cancer, but might need to have another PSA test in a few months. Your doctor may recommend having a series of PSA blood tests to see whether the level is changing over time and if so, how quickly.
• PSA significantly raised You probably need to have a prostate biopsy to find out if cancer cells are present.