If you’re 50 or older, your primary care provider has likely discussed measuring your prostate-specific antigen (PSA) levels, a simple test that offers a unique look into your prostate health. When PSA levels rise, other tests, such as prostate MRI, can help pinpoint the root of any potential problem and determine your treatment plan.
Here’s what you should know about PSA levels, what they mean for you, and when you may benefit from prostate MRI.
What Is PSA?
Understanding PSA can help you feel informed and prepared to monitor prostate health.
The prostate gland is a small organ located below your bladder, and it plays a crucial role in producing a fluid that combines with sperm to form semen. PSA, or prostate-specific antigen, is a protein found in this fluid that helps keep semen flowing smoothly.
Sometimes, your prostate might produce more PSA than usual, which can indicate an issue that may need attention. A simple PSA blood test is a proactive way to catch any changes early on, even before symptoms appear.
The American Cancer Society reports that prostate cancer is the second leading cause of cancer-related deaths among men in the U.S. It’s important to note that while prostate cancer is a serious concern, many men are successfully treated today because of early detection. If you have a family history of cancer, are of Black descent, or have certain genetic factors that may increase your risk, consider talking to your healthcare provider about starting your PSA testing at age 40. For most men without these risk factors, age 45 is the recommended time to schedule your first test.
Common Causes of High PSA Levels
Anxiety about high PSA levels is completely understandable, but it’s essential to know that an increase doesn’t always mean prostate cancer. In fact, several factors can cause your PSA levels to rise, many of which are common and benign. Here are some possible reasons:
- Age. As you age, it’s quite normal for PSA levels to increase, even if you’re healthy and have no prostate issues.
- Enlarged prostate. Known as benign prostatic hyperplasia (BPH), this is a common condition that affects many men as they get older. In fact, about one in three men over 65 experience this. It’s a natural part of aging, as the prostate continues to grow throughout life, but it can lead to symptoms like frequent or painful urination or discomfort.
- Infection. If you have prostatitis — an infection or inflammation of the prostate — it can temporarily raise your PSA levels until the infection is treated.
- Medication. Some medications, particularly those that increase testosterone, can also lead to higher PSA levels.
- Prostate cancer. While this is a serious cause of high PSA levels, prostate cancer is often slow-growing and can sometimes be managed effectively if found early.
Tracking your PSA levels over time gives you a heads up if something abnormal is going on in your prostate. Your initial test provides a baseline PSA. If your level gets higher, your health provider may suggest additional testing, such as prostate MRI, to determine if you have prostate cancer or another condition.
With PSA Levels, What Is Too High?
PSA levels are measured in nanograms per milliliter (ng/ML). Higher PSA levels can signal prostate cancer, but no single number means the same thing for every man. Doctors usually divide PSA results into three risk categories that take age and overall health into account:
- PSA of 4 ng/mL or lower. At this lowest PSA level, you probably don’t have prostate cancer, though it is possible. Additional testing can confirm or rule out the disease.
- PSA of 4 – 10 ng/mL. The American Cancer Society states that your odds of having prostate cancer with PSA levels in this range are approximately one in four. If prostate cancer is present, you may have early-stage cancer that doesn’t require treatment of any type.
- PSA higher than 10 ng/mL. At this elevated PSA level, the likelihood of prostate cancer is higher than 50%, though your cancer may still be confined to the prostate and only need treatment if it begins to grow.
It’s important to work with your physician to monitor your prostate health over time, regardless of your PSA test results. Report any new symptoms that arise with your prostate, undergo PSA testing as recommended by your provider, and follow up with additional tests to get to the bottom of your condition.
When You Could Benefit From a Prostate MRI
If your PSA rises or your care provider wants more information to characterize your prostate health, your physician may write an order for a prostate MRI. This imaging exam helps visualize prostate health, including cancer, so your care team can identify any concerns and develop a treatment plan, depending on whether cancer is present and has grown beyond the prostate and other factors.
Your provider may recommend a prostate MRI in the following situations:
- Early-stage cancer diagnosis. Some cases of early-stage prostate cancer benefit from active surveillance instead of immediate treatment. Prostate MRI provides a noninvasive way for your health provider to monitor prostate cancer without biopsies to determine if and when treatment is appropriate.
- Rising PSA. An increase in PSA may lead your provider to want more information about your prostate health, which a prostate MRI provides.
- Steady PSA. If you have consistently high PSA, a prostate MRI can provide more information that may help detect prostate cancer or other conditions.
In some cases, prostate MRI prevents you from needing an ultrasound-guided biopsy, as the MRI clearly shows there is no cancer present. In the event cancer is seen on the MRI, your health provider may recommend a prostate biopsy to help determine the type and stage of cancer.
Along with prostate cancer, prostate MRI is an excellent tool to help detect or evaluate other issues that cause rising PSA levels, such as prostate infection or an enlarged prostate.
Windsong — Your Partner in Prostate Health
When high PSA levels require additional testing, Windsong Radiology is your trusted partner in monitoring prostate health. We are the first in the region to provide Multiparametric Prostate MRI, a specialized type of imaging that uses multiple MRI sequences to evaluate the prostate in detail. Our 3T MRI machine has a stronger magnet than regular MRIs, which means it produces even clearer images, helping doctors identify any issues early.
Thanks to this sophisticated imaging technology, you get a quick prostate imaging exam that provides the maximum amount of information possible to your care team. In the event cancer or another condition is present, your prostate MRI can help lead to a diagnosis, so you can begin treatment as soon as possible.
