Avoid Random Biopsy: PSA Screening Flowchart
Elevated PSA does not point specifically to prostate cancer; it is only an indication that further investigation is necessary. Each year one million men are biopsied when they do not …
P/ 310-827-7707 | F/ 310-574-4002 | MAIL@PROSTATEONCOLOGY.COM
An abnormal PSA may need further evaluation, possibly a biopsy since it may be a sign of underlying aggressive prostate cancer.
However, PSA should only be considered “abnormal” when:
It is consistently elevated upon repeat testing after abstaining from sex for 48 hours.
-A prostate infection has been ruled out by rechecking the PSA after a trial of antibiotics.
-PSA is higher than what is expected in relation to the size of the prostate as determined by ultrasound scanning. The normal ratio is one point of PSA for each 10 cc of prostate volume. Greater than 1.5 points of PSA per 10 cc of prostate is abnormal.
-PSA is rising faster than what would be expected due to the normal increase from aging. The normal rate of rise due to aging is less than 0.4 points per year. (Accurate comparisons require year to year PSA comparisons from the same lab).
-Free-PSA is less than 10% and no underlying infection is suspected.