The Next Steps After An Abnormal PSA

Prostate-specific antigen (PSA) test is a blood test used as a screening tool to help diagnose prostate cancer. Although an elevated PSA can be consistent with cancer, it is possible to have an abnormal PSA without cancer. The next steps after an abnormal PSA are imperative to identifying cancer if it exists. 


The only definitive test to diagnose prostate cancer is a biopsy. There are several techniques used to perform a biopsy. A tissue sample is usually collected with a long needle under imaging guidance. It is necessary to take several tissue samples from various regions of the prostate to determine where cancer is in the prostate if it occurs. The results of a biopsy go beyond finding out whether or not you have cancer. If you have prostate cancer, a biopsy provides additional information, such as the grade of cancer and staging. Sometimes the results of a biopsy determine you do not have cancer, but have high-grade changes in the prostate cells that have a high likelihood of becoming cancerous.

Genetic And Receptor Testing

If the biopsy indicates you have prostate cancer, the next step might be genetic testing. Genetic testing can help doctors make better decisions regarding treatment. Cancers with certain genetic markers might historically respond better to specific types of chemotherapy or other treatments. Testing to determine which, if any, receptors exist in prostate cancer can also dictate treatments. Some forms of prostate cancer may have hormone receptors, especially androgens. With this information, taking medications to lower the number of androgens may be helpful in slowing the progression of cancer or causing some masses to shrink.

Treatment Decisions

Treatment options will depend on your unique situation, such as genetic and receptor information for your cancer, staging, and lifestyle. Surgery is often the first step in treating prostate cancer, but if the cancer is diagnosed at a later stage, the risks of surgery may outweigh the potential benefits. Generally, chemotherapy is prescribed for prostate cancer at almost every stage. The objective of chemotherapy can be different, based on the stage. Doctors might recommend chemotherapy in the earlier stages because it's potentially curative, while chemotherapy in late-stage cancers might be palliative.

Radiation therapy is frequently used as a treatment. If cancer has not spread beyond the prostate, there may be a good chance of radiation halting the progression of cancer. Immunotherapy is increasingly common for some types of cancer. This treatment helps encourage your immune system to destroy cancer cells. These treatments are often reserved for situations when conventional treatments have been unsuccessful.

An abnormal PSA does not guarantee you have prostate cancer, but it does increase the likelihood of cancer. After an elevated PSA, there are other tests and decisions that need to be made to treat cancer, if it occurs.

To learn more about prostate cancer testing, reach out to a healthcare provider near you.