“At what PSA level should a biopsy be done?”

Elevated PSA levels can indicate the appearance of cancer; however, non-cancerous conditions can cause elevation of PSA such as (benign prostatic hypertrophy BPH), and infections. For men in their 40 – 50 with PSA score greater than 2.5 ng/dL; normal range 0.6 and 0.7ng/d; men in their 60s with PSA score greater than 4.0 ng/dL normal range 1.0 and 1.5ng/dL Abnormal PSA is considered abnormal is you PSA rises more than 0.35ng/dL in a year. There are many tests. Digital examination test (DRE) is one of the tests that continue to be reliable in term of findings. This means that your Dr. must examine you physically through the rectum to check the prostate gland. During the exam he is looking for nodularity of the gland, if it is soft or hard, painful etc. The most accurate is a prostate biopsy. Prostatic screening episwitch (PSE) blood test is 94% accurate and better than the Prostatic Specific Antigen PSA) test. Magnetic resonance imaging in recommended in some situation to get a better and more detain picture. Thank you.

In general, a PSA level ≥4.0 ng/mL is considered elevated and should prompt repeat testing (to confirm that this is not a spurious result). If confirmed, then you should see a urologist for further consultation since many things besides prostate cancer can cause at least transient PSA elevations. If you have any risk factors for prostate cancer (e.g. family history, certain genetic cancer predispositions, age over 50 years) I would definitely follow up on this with a urologist who may recommend prostate biopsy which is the only way to definitively diagnose prostate cancer. If you send me your email address, be happy to send you some patient-friendly information on this topic. David Gordon, M.D.

It depends on how high it and that is based on the urologist and other parameters such as prostate exam, etc.