An authoritative panel concludes that in older men, the PSA blood test causes more problems than benefits.

A randomized trial of over 35,000 men shows that vitamin E and selenium supplements fail to reduce the risk of prostate cancer. In this video, Dr. Anthony Komaroff discusses the findings.

Your PSA level is moderately elevated and increasing at a worrisome rate. Follow-up is needed. However, keep in mind that your risk of prostate cancer still less than 40 percent.

This may be a normal fluctuation in your PSA level. An increase in your PSA of less than 0.75 ng/ml over one year is generally felt to be reassuring. Repeat testing in 3-6 months is a reasonable option. Discuss this with your doctor.

Understanding PSA

Knowing your previous PSA levels is helpful, but not necessary. Nonetheless, your PSA level is mildly elevated. Follow-up is needed. Keep in mind that your risk of prostate cancer is still less than 40 percent.

The next thing to determine is how fast your PSA levels has been rising. You can figure this out if your PSA was checked within the past year or so. You should subtract your last PSA result from your current results. For example, if your PSA was 4.5 last year and is 5.0 this year, it has increased by 0.5 points (ng/ml) over the past year. A quickly rising PSA is worrisome, while a slowly rising PSA (or PSA level that goes down) is reassuring.

Ejaculation or vigorous bicycle riding can cause a small increase in your PSA level. Consider repeating your PSA test in two weeks, after you’ve avoided bicycle riding and intercourse for at least 48 hours. If your repeat PSA level returns to normal (less than four), this is excellent news. If your PSA test remains elevated, further evaluation is probably needed. Your options include:

PSA levels can also go up for other reasons. For example, riding a bicycle can put pressure on the prostate and cause a temporary spike in your PSA level. The same is true for ejaculation during sex or masturbation. In general, these activities cause PSA levels to rise only a little, and the PSA should return to normal within several days.

Your PSA level may be falsely elevated. This means that although your PSA level is above normal, there is a good chance that you do not have prostate cancer.

Your PSA level is moderately elevated. About one in three men with a moderately elevated PSA level will be found to have early stage prostate cancer if a biopsy is performed. Early stage prostate cancer rarely causes symptoms, and your prostate may feel totally normal when examined by your doctor (digital rectal exam). One piece of good news is that early stage prostate cancer can often be cured.

Contact your doctor. Your PSA level is high. Your risk of prostate cancer is greater than 50 percent. Immediate follow-up is warranted. Speak to your doctor about referral to a urologist (prostate specialist) or arranging for a prostate biopsy.

Your PSA level is moderately elevated. More than half of men whose PSA level is ten or above will be found to have prostate cancer if a biopsy is performed.

Your PSA level is below 4.0 ng/ml. This is generally a reassuring result, and your risk of having prostate cancer is low.

Your PSA level is in the normal range. This is a reassuring result. You have a low risk of being diagnosed with prostate cancer within the next few years.

Your PSA level is very low. This is a reassuring result. You have a very low risk of being diagnosed with prostate cancer within the next few years.

Your PSA level is in the normal range. This is a reassuring result.

Your PSA level is above four ng/ml. In younger men, this is usually considered to be a worrisome level. However, your PSA level may be normal for someone in your age group.

Given your age or medical history, many doctors would question whether it makes sense to have your PSA tested regularly. This is because prostate cancer is often a slow-growing disease, especially in older men. Even if prostate cancer is detected, the risks of side effects from treatment may be greater than any potential benefits.

Your PSA level is above the normal range. However, given your age or medical history, further evaluation may or may not be worthwhile. Speak with your doctor about appropriate follow-up.

Next, we need to know your most recent PSA test result. Usually this is a number between 1.0 and 10.0 (PSA is measured in nanograms per milliliter, or ng/ml).

Most doctors recommend waiting until age 50 to start PSA testing. That’s because prostate cancer is uncommon before this age. However, PSA levels are sometimes checked in men younger than age 50 because they have a risk factor for prostate cancer, such as having a close family member with the disease or being African-American (African American men are more likely than other men to develop prostate cancer and can develop an aggressive form of the disease at a young age).