Prostate Cancer & Elevated PSA

Several factors can increase a man’s risk of developing prostate cancer. These include:

• Age – Risk rises significantly after age 50. Most cases are diagnosed in men over 65.

• Family history – Having a father, brother, or close relative with prostate cancer increases your risk, especially if they were diagnosed at a younger age.

• Ethnicity – Men of African or Caribbean descent have a higher risk and are more likely to develop aggressive forms of the disease.

• Genetics – Inherited gene changes, such as BRCA1 or BRCA2 mutations, can raise the risk.

• Diet and lifestyle – A diet high in red meat and low in fruits and vegetables may contribute, while obesity and lack of exercise are also linked to higher risk.

Knowing your risk can help guide decisions about screening and early detection. If you're in a higher-risk group, it's important to talk to your doctor about when to start checking your prostate health.

In its early stages, prostate cancer often causes no symptoms, which is why regular check-ups and PSA testing are important for early detection. When symptoms do appear, they may include:

• Frequent urination, especially at night

• Difficulty starting or stopping urination

• Weak or interrupted urine flow

• Pain or burning during urination

• Blood in urine or semen

• Pain in the lower back, hips, or pelvis (if the cancer has spread)

• Erectile dysfunction or discomfort during ejaculation

These symptoms can also be caused by non-cancerous conditions like an enlarged prostate (BPH), so it’s important to see a doctor if you notice any changes. Early diagnosis gives more treatment options and better outcomes.

Diagnosing prostate cancer usually begins with a combination of tests to check for signs of the disease and assess your prostate health:

1. PSA Blood Test
   Measures the level of prostate-specific antigen in your blood. A higher PSA may indicate prostate cancer, but it can also rise due to other prostate conditions like BPH or prostatitis.

2. Digital Rectal Exam (DRE)
   Gentle examination of the prostate through the rectum to check for lumps, hard areas, or other irregularities.

If these tests suggest something unusual, further evaluation may include:

• MRI Scan – gives a detailed image of the prostate and helps guide the next steps.

• Prostate Biopsy – a small sample of prostate tissue is taken and examined under a microscope to confirm if cancer is present.

• Genomic or blood tests – sometimes used to assess cancer risk or aggressiveness.

Early detection is key. If you’re over 50 or have risk factors, talk to us about when and how often you should be screened.

PSA (Prostate-Specific Antigen) is a protein produced by cells in the prostate gland. It’s found in small amounts in the blood of all men, but higher levels can sometimes be a sign of prostate problems — including prostate cancer, benign prostatic hyperplasia (BPH), or prostate inflammation (prostatitis).

A PSA blood test measures how much of this protein is in your bloodstream. While a high PSA level doesn’t always mean cancer, it can prompt further testing to find out what’s causing the change.

PSA testing is often used to screen for prostate cancer, especially in men over 50 or those at higher risk. It’s also used to monitor prostate conditions or track treatment progress after a prostate cancer diagnosis.

An elevated PSA level means that the amount of prostate-specific antigen in your blood is higher than what’s considered typical for your age. While this can be concerning, it’s important to know that a high PSA doesn’t always mean you have prostate cancer.

There are several possible reasons for an elevated PSA, including:

• Benign prostatic hyperplasia (BPH) – an enlarged but non-cancerous prostate

• Prostatitis – inflammation or infection of the prostate

• Recent ejaculation or vigorous exercise – especially cycling

• Urinary tract infections

• Prostate cancer – especially if the PSA is persistently high or rising

If your PSA is elevated, we may recommend repeat testing, a digital rectal exam (DRE), or further investigations such as an MRI or prostate biopsy to find the cause. It’s the trend and context — not just one PSA number — that guide what happens next.

If your PSA level is elevated, we will consider several factors — including your age, medical history, and how high the PSA is — before deciding on next steps. Additional tests may include:

1. Repeat PSA Test
   Sometimes, a second test is done a few weeks later to confirm the result and rule out temporary causes (like infection, exercise, or recent ejaculation).

2. Digital Rectal Exam (DRE)
   A gentle examination of the prostate through the rectum to check for lumps, hardness, or other changes that may suggest cancer.

3. Urine Tests
   These help rule out infections or check for certain markers linked to prostate cancer.

4. Prostate MRI
   A multi-parametric MRI provides a detailed image of the prostate and can help identify any suspicious areas before a biopsy is done.

5. Prostate Biopsy
   If concerns remain after imaging, a biopsy may be recommended. This involves taking small samples of prostate tissue to look for cancer cells under a microscope.

6. Advanced Biomarker or Genomic Tests
   In some cases, newer blood or urine tests can help assess cancer risk more accurately and decide if a biopsy is needed.

These steps help build a clearer picture of your prostate health and guide whether treatment, monitoring, or no further action is needed.

Treatment for prostate cancer depends on several factors — including the stage of the cancer, how aggressive it is, your age, general health, and personal preferences. Common treatment options include:

1. Active Surveillance
   For slow-growing cancers that may not cause harm, regular monitoring with PSA tests, MRIs, and occasional biopsies can be done instead of immediate treatment.

2. Surgery
   Radical prostatectomy involves removing the entire prostate gland and is often used if the cancer is confined to the prostate and you're in good health.

3. Radiation Therapy
   This uses high-energy beams to kill cancer cells. It can be given externally (external beam radiation) or internally (brachytherapy, where tiny radioactive seeds are placed in the prostate).

4. Hormone Therapy
   Also called androgen deprivation therapy (ADT), this reduces or blocks testosterone, which fuels prostate cancer growth. It's often combined with radiation or used in advanced cases.

5. Chemotherapy
   Used mainly for advanced or aggressive prostate cancers that don't respond to hormone therapy.

6. Targeted and Immunotherapy
   In selected cases, newer treatments like PARP inhibitors or immune-based therapies may be used, especially if genetic testing reveals certain mutations.

We will help tailor a treatment plan that balances effectiveness with quality of life. Many men with prostate cancer live long, healthy lives — especially when it's caught early.