)    PSA (prostate-specific antigen) blood test

A normal PSA is less than 4.0 ng/mL. If the PSA level is greater, it is more likely that prostate cancer is present. However, there are other conditions that can raise the PSA. Men with a PSA level between 4.0 and 10.0 ng/mL have about a 25 percent chance of having prostate cancer. If the PSA level is greater than 10.0ng/mL, the chance of having prostate cancer is over 50 percent. If you have a high PSA, a doctor will look at other factors such as age, race, and family history, and also rule out any other possible conditions causing the elevated PSA. If other conditions have been ruled out, the doctor will recommend a prostate biopsy.

Other factors that could increase the PSA level include:

·         Prostatitis: Prostatitis is an infection or inflammation of the prostate gland.

·         Older age: Men may have a higher PSA level as a result of older age. This can occur even without any condition affecting the prostate.

·         Enlarged prostate: BPH (benign prostatic hyperplasia) can increase the PSA level. BPH is condition in which the prostate becomes enlarged. It is not cancerous. This usually occurs in men as they get older.

·         Ejaculation: After a man ejaculates, the PSA level can increase for a short period of time and eventually goes back down again. Doctors usually recommend that men refrain from ejaculating for at least two days prior to having a PSA test.

·         Urologic procedures: A prostate biopsy or cystoscopy can increase the PSA level. A DRE may also increase the PSA level. The PSA level goes down within a short period of time after having these procedures. Doctors recommend having a PSA test prior to having these procedures.

·         Certain medications: Medications like male hormones (testosterone) or other medications that increase testosterone levels may increase the PSA level.

·         Bike riding: Studies have shown that bike riding may increase the PSA level. This is likely due to the pressure that a bicycle seat places on the prostate gland as a man sits on a bike.  

2)    Special types of PSA tests

·         Percent-free PSA: A lower free PSA level indicates a higher likelihood that prostate cancer is present.

·         PSA velocity: The PSA velocity may be faster in men with prostate cancer.

·         PSA density: The greater the PSA density, the more likely it is that prostate cancer is present.

·         Age-specific PSA: Whether cancer is present or not, older men usually have higher PSA levels than younger men. A high PSA level may be of more concern in a man who is 50 years old than in a man who is 80 years old.

3)    Digital rectal exam (DRE): A digital rectal exam not as effective as the PSA blood test in detecting prostate cancer. However, it is still a good way to identify any abnormal nodules that may be present on the prostate gland. It can also sometimes find prostate cancer in men who have a normal PSA level.