Understanding PSA and Prostate Health

PSA (prostate-specific antigen) is a protein made by the prostate and measured with a simple blood test. It rises with prostate cancer — but also with benign enlargement, infection, recent ejaculation, cycling and instrumentation. It is an organ-specific test, not a cancer-specific one.

Because of this, a raised PSA does not diagnose cancer, and a normal PSA does not completely exclude it. When PSA is elevated, current practice is to repeat the test under standard conditions, exclude infection, and often obtain an MRI of the prostate before deciding whether a biopsy is needed. This pathway has reduced unnecessary biopsies considerably.

Whether to have PSA testing at all is a personal decision best made after discussion. International guidelines suggest shared decision-making for men roughly between 50 and 70, and earlier (around 40–45) for men with a family history of prostate cancer or of African ancestry. Testing has potential benefits (earlier detection) and potential harms (overdiagnosis of slow-growing cancers that would never have caused harm), and understanding both sides is the point of the discussion.

If prostate cancer is found, remember that many low-risk cancers are safely managed with active surveillance rather than immediate treatment. A PSA result is the start of a conversation, not a verdict.