An elevated prostate-specific antigen (PSA) level can be concerning, but it doesn’t necessarily mean you have prostate cancer. There are several reasons PSA levels can be higher than normal, including some that aren’t related to cancer.

If your PSA is elevated, your doctor will look at your results and other factors to determine what should happen next. Depending on your situation, that could mean monitoring your PSA or having additional testing, such as an MRI or biopsy.

What does an elevated PSA mean?

PSA is a protein made by the prostate gland. Higher PSA levels can sometimes be a sign of prostate cancer, but cancer isn’t the only reason PSA levels can rise.

PSA can also rise because of:

• An enlarged prostate
• Inflammation
• Infection
• Trauma to the prostate

Age can also affect PSA levels, which tend to increase as men get older.

That’s why an elevated PSA alone can’t tell you whether you have prostate cancer.

What happens after an elevated PSA result?

Your next step is to talk with your doctor about your results. According to the American Cancer Society, depending on your PSA level and other factors, your doctor may recommend:

• Repeating the PSA test: PSA levels can change over time, so your doctor may recommend checking your level again.
• Getting additional tests: Other blood or urine tests, a digital rectal exam (DRE), or an MRI may help your doctor better understand your risk of prostate cancer.
• Having a prostate biopsy: In some cases, your doctor may recommend a biopsy, which removes small samples of prostate tissue to check for cancer cells.

Before deciding what to do next, consider asking your doctor:

• What could be causing my PSA to be elevated?
• Do you recommend repeating my PSA test?
• Do I need any other tests?
• What do you recommend as my next step, and why?

Your doctor can walk you through your options and help you decide what makes sense for you.

What happens if your doctor recommends a biopsy?

If your doctor recommends a prostate biopsy, you may have questions about whether you need an MRI first and what to expect from the procedure.

Do you need an MRI before a biopsy?

Not everyone will need an MRI before a biopsy. An MRI can help doctors look for suspicious areas in the prostate. If a biopsy is needed, MRI images can also help your doctor target areas that look suspicious when taking tissue samples.

What happens during a prostate biopsy?

During a prostate biopsy, a doctor uses a needle to remove small samples of tissue from the prostate. The samples are then sent to a lab, where a pathologist examines them for cancer cells.

Your doctor can explain how the biopsy will be performed, what you may experience during and after the procedure, and any potential risks.

What should you ask before scheduling a biopsy?

If your doctor recommends a biopsy, consider asking:

• Why do you recommend a biopsy for me?
• Should I have an MRI before the biopsy?
• How will the biopsy be performed?
• What are the potential risks?
• What should I expect during and after the procedure?
• When will I get my results?

Cancer Care for Carrum Health members

If you or an eligible family member has received a cancer diagnosis—or test results indicate the possibility of cancer—Carrum Health can connect eligible members with a leading cancer center and guide you through your next steps.

For eligible members, prostate cancer treatment through Carrum Health is typically fully covered, so you won’t receive a bill for eligible care.

To see if the Carrum Health cancer care benefit is available to you, check your eligibility.

The information contained on this page is for informational purposes only. No material is intended to be a substitute for professional medical advice, diagnosis, or treatment.