What happens if you have a raised PSA?
Overview by Professor Caroline Moore
University College Hospital London, NHS Trust
The Urologist will discuss a number of things:
- Take your family history and how long you have had your symptoms (if you have any)
- Order another PSA test, to check that the first one was not an abnormal reading
- Ask you to give a urine sample (if you have not had one already) to see if the PSA could be raised due to infection
- If your PSA comes back in the normal range for your age, you will probably be released back to your GP, with a request to check your PSA again in 3-6 months.
If the Urologist does not believe that your symptoms are caused by prostatitis or an enlarged prostate, it is likely you will be referred for a multiparametric MRI scan. If you have an MRI scan you will have a follow up appointment with the Urologist after the scan who will explain the results, and the next steps – if any.
Prostate MRI scans are assessed by radiologists, who use a 1-5 scoring system, to indicate the likelihood of cancer in the prostate. If you have a score of 4 or 5, you will be advised to have a biopsy of the prostate, as long as you are fit to do so. If you have a score of 1 or 2 you have a very low likelihood of having a prostate cancer that would affect you. A score of 3 is often combined with the PSA density calculation (PSA in ng/ml divided by prostate volume in mls) to help stratify your risk of having cancer, and to help decide whether or not you should have a biopsy.
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