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Your PSA is Elevated, What Happens Next?

June 20, 2012

When it comes to maintaining your good health, fewer things in life promise better odds than preventive care. So what happens next if you’ve dutifully gotten your PSA screening, only to learn that your PSA levels are elevated?

Though members of a recent U.S. Preventive Services Task Force might argue that you shouldn’t even have been tested, I believe your follow-up care remains as important as the initial testing.

It’s important to understand that a high PSA test doesn’t always signal prostate problems. You might be surprised to learn that your PSA levels can fluctuate throughout the month. Because of this natural change, your doctor will likely (and really should) perform another PSA test about four to six weeks after the initial test. The time frame allows the body’s PSA levels to normalize, resulting in a more accurate test.

If the levels are still high after the second test, your doctor might recommend a digital rectal exam that screens for structural abnormalities in the prostate. Your doctor will then read the images and consider other signs and symptoms to determine if a biopsy is necessary. Additional indicators of prostate cancer include difficulty urinating, decreased urine stream flow, blood in the urine and/or semen, swollen legs, pelvic discomfort and bone pain.

If your doctor decides a prostate biopsy is necessary, it’s not necessarily cause for alarm. Most prostate biopsies are transrectal — a thin needle is inserted through the urethra in order to take multiple samples from the prostate glad. While I will admit that the procedure can be a bit uncomfortable, the discomfort is negligible when weighing the risks of unchecked cancer.

A high PSA doesn’t always signify cancer, but following up after an elevated test is key for early detection and care. Don’t gamble on your health, follow your doctor’s advice and be sure to schedule a follow-up appointment.

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