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WHAT HAPPENS IF MY PSA IS HIGH? If you had normal results on a digital rectal examination and your PSA is slightly high, your doctor may want to repeat the test later to see if the PSA remains high. It is important to follow up with your doctor if something unusual is found on the digital rectal exam or if your PSA level is high. If your doctor has ordered more tests or suggested repeating the PSA test, keep your appointments. Don't let fear keep you from having the tests you need to detect - or help rule out - cancer. Prostate cancer is most successfully treated when found early. The PSA test does not provide a perfect method for screening. Approximately 15% of men with prostate cancer have a normal PSA level. In order to confirm the presence of cancer, men with raised PSA levels are referred as an out-patient to a Urology Clinic for a biopsy. About two thirds of men with an elevated PSA level do not have a cancer detected in a biopsy. How is prostate cancer diagnosed? A diagnosis of prostate cancer must be made by a biopsy. During a biopsy, several small pieces of prostate tissue are removed with hollow needles and then examined under a microscope for cancer. The biopsy sampling takes about 20 minutes and can be very painful and so you may want to ensure an anaesthetic is used If cancer is found in a sample removed by biopsy, a Gleason score is used to describe the aggressiveness of the cancer. Patients may then be given a CT scan and a bone scan to assess the spread of the cancer and to describe the staging of the cancer. For more information on Gleason scores see: http://www.prostate-cancer.org.uk/info/prostate_cancer/tests_grading.asp
For more information on the tests and their possible outcomes see:
http://www.prostate-cancer.org.uk/info/prostate_cancer/cancer_diagnosis.asp
There is a wide variation in the advice given by GPs and specialists on PSA test results, Gleason readings etc. and the treatment choices that follow. Members of Prospect have been down this route before, and you may find a discussion with them helpful (via the Help Line or by attending a meeting). They have the experience of viewing the whole process from the patient's point of view.
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