What should I do about an abnormal PSA result at a health screening?

The above 2 doctors have given a wonderful set of answers. I would suggest a repeat PSA to see the trend, as well as to evaluate with your doctor whether there are symptoms which could suggest prostatitis or some form of perineal trauma during sexual encounters.

Generally tumor markers (such as PSA) are more useful as monitoring tools, rather than diagnostic screening markers.

You may want to check out this article on health screening in Singapore here.

As pointed out by Dr Hwee Yong, there are many causes for an elevated PSA test, so the doctor must interpret these findings on the background of asking questions related to your history (eg. any urinary symptoms? Any weight loss? Any blood in your urine? etc), as well performing a proper clinical examination (in this case, a prostate examination).

As a next step, I’d suggest seeing either a GP at a private or polyclinic. He will be able to advise you on the follow-up after determining the answers to the above.

Cheers

There can be other causes for raised PSA other than cancer, like prostate inflammation, infection, benign enlargement or perineal region trauma.

The first step is to rule out all these reasons that may be causing the elevated PSA.

Should there be a need for more advanced measurement of PSA parameters, your physician can further advise.

It would be good for you to see a urologist for a full clinical consultation and examination before proceeding further.

PSA testing is done for the early detection of prostate cancer.

However, an abnormal PSA is not specific for prostate cancer alone. There are other causes of an abnormal PSA such as:

• Enlarged benign prostate (BPH)
• Urinary tract infections
• Recent ejaculation etc.

The risk of prostate cancer depends on how abnormal the PSA is. For example,

• Risk of prostate cancer for PSA 4-10ng/ml—around 25%,
• Risk of prostate cancer for PSA 10-20, around 33-50%.

The risk of cancer increases as the PSA increases.

I would suggest that you see a urologist for further assessment. If there are no other obvious causes of an abnormal PSA, further tests may be offered to check for prostate cancer. This includes an MRI of the prostate and/or a prostate biopsy.

If you suspect that you are suffering from prostate cancer, you may read this article on the ultimate guide to dealing with prostate cancer as advised by a Singaporean Urologist