Patient Education · Prostate Health
A complete plain-language guide to PSA testing — what your number means, what causes it to rise, who should be tested, and exactly what happens if yours is elevated.
PSA (Prostate-Specific Antigen) is a protein produced by the prostate gland. Small amounts leak into the bloodstream and can be measured with a simple blood test. PSA is not a cancer marker — it is a prostate marker. It rises whenever the prostate is stressed, inflamed, enlarged or cancerous.
PSA rises with age as the prostate naturally enlarges. It also rises with prostate infection (prostatitis), benign prostate enlargement (BPH), vigorous exercise, recent sexual activity, urinary catheterisation — and prostate cancer.
This is why a raised PSA alone does not mean cancer — but it does always warrant specialist investigation to establish the cause.
These are general guidelines only. The trend over time and other clinical factors are often more important than a single reading.
If you have no symptoms and no family history, consider having a baseline PSA from age 50. Prostate cancer commonly causes no symptoms in its early, most curable stages.
If your father or brother was diagnosed with prostate cancer (especially under age 65), your risk is approximately double. PSA testing from age 40–45 is recommended.
Black men in the UK have a significantly higher lifetime risk of prostate cancer (approximately 1 in 4 vs 1 in 8 for white men). Proactive screening from age 40 is strongly recommended.
Lower urinary tract symptoms (slow stream, frequency, urgency) warrant a PSA test as part of a full assessment, even if BPH is the more likely diagnosis.
PSA should not be measured within 48 hours of ejaculation, vigorous cycling, or digital rectal examination, and not during a urinary infection — these can falsely elevate the result.
Prostate cancer kills over 12,000 men in the UK each year — yet when caught early, it is almost always curable. The tragedy is that it often causes no symptoms until advanced. A simple blood test can change that outcome entirely.
— Dr Torath Ameen, FRCS (Urol)Mr Ameen will review your PSA trend (not just one reading), take a full history, and perform a clinical examination including digital rectal examination (DRE) — quick, painless and essential.
NICE guidelines recommend an mpMRI as the first investigation after an elevated PSA — before any biopsy decision. The MRI identifies suspicious areas within the prostate (PIRADS score 1–5) and guides whether a biopsy is needed at all.
If the MRI shows a PIRADS 3–5 lesion, Mr Ameen performs an MRI-fusion biopsy — combining the MRI image with real-time ultrasound to target the specific area of concern. Far more accurate than traditional random biopsy, with fewer unnecessary samples.
One consultation can give you the answers and the peace of mind you need. Mr Ameen sees patients typically within 1–2 weeks.