PSA Test

What is a PSA test?

A prostate-specific antigen (PSA) test measures the amount of PSA in your body. PSA is a protein that your prostate gland makes. Normal and cancerous prostate tissue make PSA. However, prostate cancer tends to produce it in higher amounts. High PSA levels may indicate prostate cancer.

Healthcare providers recommend PSA tests for men and people assigned male at birth (AMAB) to screen for prostate cancer. Catching prostate cancer early with a PSA test increases your chances of effective treatment.

A healthcare provider will usually conduct a digital rectal exam (DRE) along with a PSA test.

What does a PSA test tell you?

A PSA test tells you if you have elevated PSA levels.

What is a normal PSA by age?

A normal PSA depends on your age. Your PSA levels slowly increase as you age, even if you don’t have prostate cancer or any other prostate conditions. Abnormal PSA levels may indicate prostate cancer.

Healthcare providers measure PSA in your blood in nanograms per milliliter of blood (ng/ml).

How can I lower my PSA quickly?

There’s no guaranteed way to lower PSA. However, some research suggests that changes to your lifestyle and diet may help lower your PSA levels. These tips include:

• Eating more foods that contain lycopene. Lycopene is a chemical that gives certain fruits and vegetables their pink or red color. It may have potential anti-cancer properties. Foods that contain a lot of lycopene include tomatoes, watermelon, apricots, grapefruit and pink guavas.
• Consider a plant-based diet. A diet high in vegetables and legumes may increase your immunity and prevent cancer cell growth.
• Take vitamin D. Vitamin D helps build and maintain strong bones and boosts your immune system. Your body makes vitamin D when you spend time in the sun. Foods that contain vitamin D include fatty fish and vitamin D-fortified items such as milk, plant-based milk, orange juice, cereal and oatmeal. A healthcare provider may also recommend vitamin D supplements.
• Increase physical activity. Moderate to vigorous physical activity can help reduce your PSA levels. Activities include walking, jogging, weight-lifting and recreational sports.

What are the symptoms of high PSA?

High PSA levels don’t cause symptoms, but they may indicate prostate cancer. Prostate cancer often doesn’t have symptoms (asymptomatic), but symptoms can include:

• Difficulty urinating (peeing).
• Peeing more than usual, especially at night.
• A slow or weak pee stream.
• Pain while peeing (dysuria).
• Trouble holding your pee (urinary incontinence).

• Pain in your lower back, hip or chest.

When should you have a PSA test?

Healthcare providers recommend getting a PSA test if you’re at risk of prostate cancer. Guidelines for PSA screening exist for the following age groups:

• Age 55 and younger: People at high risk for prostate cancer, including those with a biological family history of prostate cancer and Black men.
• Age 55 to 69: Screening for people at average risk for prostate cancer.
• Over 70: Healthcare providers don’t recommend screening.

If you have prostate cancer, a provider may also recommend a PSA test to assess the effectiveness of your treatment or to make sure prostate cancer hasn’t come back.

How common are these procedures?

PSA tests are very common.

If your PSA tests are within normal levels, you may only need a new test every two years.

If your PSA tests are at abnormal levels, a provider may recommend close observation with PSA tests and other screenings every six to 12 months.

What happens before a PSA test?

Before a PSA test, tell your healthcare provider if:

• You’re taking medications for benign prostatic hyperplasia (BPH), including finasteride (Proscar®) or dutasteride (Avodart®).
• You’re taking finasteride (Propecia®) for hair loss.
• You’ve had surgery to treat BPH, including transurethral resection (TUR).
• You’ve had a prostate biopsy in the previous six weeks.
• You’ve recently had a urinary catheter or another procedure that affects your urinary system.
• You have a condition that affects your liver, such as liver cirrhosis, cystic fibrosis or hepatitis C.
• You have a urinary tract infection or have had one in the previous three months.

These medications or procedures can affect your PSA levels, which prevent your provider from getting an accurate reading. Your provider will also give you directions a few days before your PSA test to help get an accurate reading. These include:

• Don’t engage in any sexual activity 48 hours before your PSA test, including masturbation. Ejaculating may cause your PSA levels to rise temporarily.
• Don’t exercise 48 hours before your PSA test. Vigorous exercise — especially bicycling — can temporarily raise your PSA levels.

What happens during a PSA test?

Your healthcare provider will disinfect the skin around a vein in your arm with iodine, isopropyl alcohol or another skin cleaner. They’ll then use a thin (21 gauge, slightly smaller than the size of a standard earring) to withdraw a small amount of blood from a vein in your arm. They’ll send your blood sample to a lab for analysis. You may feel a tiny pinch as the needle enters or exits your skin. However, the blood draw usually lasts fewer than five minutes. You may have bruising or light bleeding after your blood test. Bruising usually goes away after a few days.

What happens after a PSA test?

After your healthcare provider removes the needle, they’ll put pressure on the puncture wound to help stop any bleeding. They’ll then place a bandage on your skin. Keep the bandage on for a few hours and avoid getting it wet. It’s also a good idea to avoid exercising for a few hours after your blood test.

When should I know the results of my PSA test?

You should get the results of your PSA test within a week. Your healthcare provider will let you know when to expect your results. They’ll discuss your results with you at a follow-up appointment.

What are the advantages of a PSA test?

The main advantage of a PSA test is detecting prostate cancer before you have symptoms or changes in your body that could become prostate cancer. It can also find prostate cancer before it spreads to other areas of your body.

What are the risks or complications of a PSA test?

Risks or complications of a PSA test include:

• Other conditions besides prostate cancer may cause elevated PSA levels, including benign prostatic hyperplasia (BPH), prostate enlargement and inflammation (prostatitis) and UTIs. This can cause concern or the need for additional tests.
• Some types of prostate cancer don’t cause elevated PSA levels. You may have prostate cancer even if a PSA test says your levels are normal.
• You may feel nauseated, light-headed or tired during or immediately after your blood test.
• You may have bruising or pain at your needle injection site for a few days.

What is the recovery time?

After a blood test, it’s a good idea to wait at least 10 minutes before you leave your provider’s office. If you feel light-headed, nauseated or tired, lie down until you feel better and drink plenty of fluids.

Any bruising should go away within a week.

When should I see my healthcare provider?

See a healthcare provider to consider a PSA test if you:

• Have a prostate and are 55 or older.
• Have an increased risk of prostate cancer (personal or family history of prostate cancer or are Black)
• Have symptoms of prostate cancer.

A note from Cleveland Clinic

A PSA (prostate-specific antigen) test provides important information about your prostate health. It’s a good idea to get regular PSA tests once you reach your 50s. However, talk to your healthcare provider about getting a PSA test earlier if you have elevated risks. Make sure you follow their instructions before the test to ensure you get the most accurate results. If you have any questions, your provider is there to help.