Prostate cancer screening is a vital component of men’s health, designed to detect cancer early, often before symptoms arise. The primary tool used is the prostate-specific antigen, or PSA test screening. This simple blood test measures the level of PSA, a protein produced by the prostate gland. Conversations around the appropriate prostate cancer screening age and what to do after an elevated result can feel complex. Understanding the process, including the crucial abnormal PSA next steps, empowers you to make informed decisions about your health in partnership with your healthcare provider.
The medical team at Doral Health & Wellness provides expert guidance on prostate cancer screening and follow-up care. We are committed to offering clear, reliable information and a supportive environment, ensuring you have the resources to manage your health with confidence.
What is a PSA Test Screening?
Prostate-specific antigen (PSA) is a substance made by the prostate. While it is normal for small amounts of PSA to be in the blood, a high level can be a sign of prostate cancer. However, an elevated PSA does not automatically mean you have cancer. Other conditions can also raise PSA levels, including:
- Benign Prostatic Hyperplasia (BPH) – A non-cancerous enlargement of the prostate.
- Prostatitis – Inflammation or infection of the prostate gland.
- Recent Urological Procedures – A recent exam or procedure can temporarily elevate PSA.
- Age – PSA levels naturally tend to increase as you get older.
Because of these factors, the PSA test is viewed as a screening tool, not a definitive diagnostic test. It is the first step in a comprehensive evaluation process.
Determining the Right Prostate Cancer Screening Age
Current guidelines emphasize a process called shared decision-making. This means you and your doctor should discuss the pros and cons of screening to decide what is best for you. The conversation should consider your personal risk factors.
- Average Risk – For men at average risk, discussions about screening typically begin around age 50.
- High Risk – Men at higher risk should start the conversation earlier, around age 40 to 45. This group includes:
- Black men, who have a higher incidence and mortality rate from prostate cancer.
- Men with a first-degree relative (father, brother, or son) diagnosed with prostate cancer before age 65.
- Very High Risk – Men with more than one first-degree relative diagnosed at an early age should consider discussions starting at age 40.
The goal is to create a personalized screening plan. A consultation with a trusted urology doctor is the best way to assess your individual risk.
Abnormal PSA Next Steps: What to Expect
Receiving news of an elevated PSA level can be concerning, but it is important to remember that this is a prompt for further investigation, not a diagnosis. A structured approach helps determine the significance of the result.
Initial Follow-Up Tests
Your doctor may recommend one or more of the following steps:
- Repeat the PSA Test – Sometimes, a result can be a temporary fluctuation. A second test confirms if the level remains elevated.
- Digital Rectal Exam (DRE) – During a DRE, a doctor feels the prostate for any hard, lumpy, or abnormal areas.
- Advanced PSA Tests – Tests like the Free PSA Percentage, PSA Velocity (the rate of increase over time), or PSA Density can provide more specific information and help assess risk.
Advanced Diagnostics
If concerns persist after initial follow-up, more advanced testing may be necessary. Searching for the best urologist near me who has access to modern diagnostic tools is important.
- Multiparametric MRI (mpMRI) – This advanced imaging scan provides a detailed picture of the prostate, identifying suspicious areas that may warrant a biopsy.
- Biomarker Tests – Other tests (urine or blood) can help further stratify the risk of having a clinically significant prostate cancer.
Prostate Biopsy
A biopsy is the only way to definitively diagnose prostate cancer. A urology doctor in NY can perform this procedure using advanced techniques.
- Systematic Biopsy – The standard approach involves taking multiple small tissue samples from different regions of the prostate.
- MRI-Targeted Fusion Biopsy – This technique combines MRI images with real-time ultrasound, allowing the urologist to precisely target suspicious areas identified on the MRI. This increases the accuracy of detecting significant cancers.
After the Diagnosis: Active Surveillance and Treatment
If a biopsy confirms prostate cancer, the next step depends on the cancer’s aggressiveness (Gleason score), stage, and your overall health. Not all prostate cancers require immediate treatment.
- Active Surveillance – For low-risk, slow-growing cancers, your doctor may recommend active surveillance. This involves closely monitoring the cancer with regular PSA tests, DREs, and sometimes repeat biopsies, without immediate treatment.
- Treatment – For more aggressive cancers, treatment options include surgery (prostatectomy) or radiation therapy, among others.
Your Partner in Prostate Health
Navigating prostate cancer screening requires clear information and expert medical guidance. From understanding the PSA test screening process to deciding on the right prostate cancer screening age and determining the abnormal PSA next steps, a knowledgeable urology doctor is your most valuable resource. Shared decision-making ensures that your values and preferences are at the center of your healthcare journey.
The expert urology team at Doral Health & Wellness is dedicated to providing comprehensive and compassionate care to the Brooklyn community. We utilize advanced diagnostics to offer clarity and develop personalized health strategies tailored to your specific needs. To schedule a consultation, contact Doral Health & Wellness today at 1-718-365-2555 or visit us at 1797 Pitkin Avenue, Brooklyn, New York 11212. For general information about Doral Health & Wellness services, you can contact or email info@doralhw.org.
