If your PSA level is too high

There are no absolute rules about what to do if your PSA level is high, and even expert doctors do not always agree on the best course of action. 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 a man of 50, a PSA of up to 2.8 nanograms* per millilitre of blood is considered normal. In a man of 70, a PSA of up to 5.3 nanograms per ml is considered normal.

As a rough guide, these are the three main options after a PSA test:

• PSA normal You are unlikely to have cancer. 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.
• PSA significantly raised You probably need to have a prostate biopsy to find out if cancer cells are present.

* a nanogram is a billionth of a gram