Elevated PSA- What’s Next: May 23, 2014

It’s often the case - men who have an elevated PSA during prostate screening do not have cancer. But many experts still stand by the test.

“Elevated PSA is usually tracked and if it accelerates rapidly, we look more at that than the actual score of the PSA itself,” says Lee Memorial Health System cancer nurse navigator Laurie Wise.

Wise works with patients at the Regional Cancer Center, and is an advocate of the PSA.

“Absolutely,” Wise says.  “Screening really does change lives and saves lives.”

Some argue the test returns too many high readings. Which is why one high PSA doesn’t a disease make. However, if subsequent tests are also elevated, a doctor is likely to look for other symptoms and consider a biopsy.

“What can happen to some men is they notice an urgency or frequency in their urination; other men they have no symptoms whatsoever.  In the very advanced stages of prostate cancer, unfortunately patients often present with bone pain,” says Wise.

A biopsy is used to confirm cancer. It’s performed by inserting a slim needle into the prostate gland and extracting tissue samples. The results are scored and represent risk.

“The Gleason score, which is one of the indicators we use when we do a biopsy, can really tell us how aggressive this cancer is. And that interpretation of that score, can really direct the physician’s treatment of the cancer.”

Men with slow growing cancer may take a watchful approach. Others may need a combination of treatments immediately. Either way- the PSA is a starting point.