PSA is a molecular marker for prostate disease. By measuring the level of PSA in your blood, your doctor can screen for a problem or potential problem in your prostate gland. A PSA blood test result above 4 is abnormally high. You would see a urologist to discuss what this means in your situation. Urologists are the medical and surgical specialists in all prostate diseases and can best interpret the meaning of this test for you.
At the very least, your urologist will want to perform a digital prostate exam to aid in accurately interpreting your PSA test. There are several possible reasons why your PSA blood test might be elevated to this level: 1. With advancing age, many men experience benign prostate gland enlargement, a process called benign prostatic hyperplasia or BPH. This process may or may not cause any symptoms. Even without symptoms, BPH can cause the PSA test to be abnormally high. Most abnormal PSA test results caused by BPH fall in this range between 4 and 10. 2. Some men may develop inflammatory conditions of the prostate, referred to as prostatitis. There are a variety of causes of prostatic inflammation, and the degree of inflammation and symptoms may vary between individuals. An acute prostate bacterial infection can cause severe symptoms and elevations of the PSA level to very high levels, even above 10.
More chronic inflammatory conditions of the prostate may cause few or no symptoms and may result in more modest elevations of the PSA blood test, between 4 and 10. 3. Some men seem to have higher than normal PSA levels without any identifiable reason. When applied to the general population, this is true of any standardized blood test. There will be a few people who typically have higher or lower levels than the vast majority of the population upon which the normal range for the test has been based. It is postulated that a few men may have naturally "leaky" prostates and may have abnormally high levels of PSA in their blood without any other pathological condition involving the prostate.
They may have PSA levels between 4 and 10 but no identifiable prostate disease. 4. Prostate cancer can cause the PSA test to be abnormally high. This is the main reason PSA blood tests are performed in adult men (to check for prostate cancer). Since prostate cancer rarely causes symptoms until it has reached advanced and incurable stages, PSA screening offers the best chance of finding prostate cancers in their early and still curable stages. Most prostate cancers with a PSA elevation between 4 and 10 are still relatively small and can be expected to respond very well to treatment. When you see a urologist about your PSA test between 4 and 10, he or she will want to carefully review your medical history, precisely any urinary symptoms you might have.
They will want to perform a digital (finger) examination of your prostate to check for benign enlargement, tenderness which might indicate inflammation, or hard spots or lumps, which might indicate cancer. Based on your personal history and this examination, your physician may recommend additional tests, including additional PSA testing, an ultrasound of your prostate, a needle biopsy, or all of these. The main goal of these tests is to determine whether your abnormally high PSA test is caused by cancer or by any one of the other benign conditions which can elevate the PSA level. As you can see, most of the prostate conditions which cause an elevation of the PSA blood test between 4 and 10 are benign and unrelated to cancer.
A thorough follow-up examination by your urologist, which demonstrates only one of these benign processes and fails to show any indication of prostate cancer, should prove reassuring. On the other hand, if prostate cancer is found based on a PSA level between 4 and 10, it will most likely be a small and early-stage cancer which will respond well to treatment and enjoy a favourable prognosis. Thus, you should be encouraged to see your urologist about elevated PSA levels and undergo whatever medical evaluation is deemed appropriate for your individual situation.