High PSA: what it means and when a biopsy makes sense
Our Oakwood Clinic at 4239 Mundy Mill Rd Suite D&E is opening soon. Until it opens, appointments are made at our Braselton Clinic, with procedures handled at our Lawrenceville Clinic & Surgery Center.
Think of a high PSA as a prompt to look closer rather than a diagnosis. Enlarged prostates, infection and even recent activity can raise it. Our urologists confirm the number, look for other causes and use MRI to decide whether a biopsy is worth doing.
What can raise a PSA besides cancer?
An enlarged prostate makes more PSA simply because there is more tissue. Prostatitis or a urinary infection can push it up for weeks. Ejaculation, a long bike ride or a recent catheter can nudge it higher. That is why one high number is usually repeated before any decision.
When does a PSA result call for a urology visit?
When your PSA is above the usual range for your age, when it has risen quickly from one year to the next, or when your doctor feels a firm area on exam. A strong family history makes the conversation more urgent.
What are the next steps after a high PSA?
We repeat the PSA, check the urine for infection and examine the prostate. Next is usually a prostate MRI, which can show areas that look suspicious. If a biopsy is recommended, it can be aimed at those areas using MRI fusion, and the transperineal route, through the skin behind the scrotum, is one approach our physicians use.
What happens on biopsy day?
The biopsy takes place at our Lawrenceville Clinic & Surgery Center with numbing medicine or light sedation, and you go home afterward. Some blood in the urine or semen for a while is expected. Our urologists review the pathology with you once it is back.
What happens after the results?
If there is no cancer, we keep tracking your PSA and treat any enlarged prostate symptoms. If cancer is found, we explain its grade and risk and walk through the options on our prostate cancer page.
What do patients ask about a high PSA?
Is a high PSA the same as cancer?
No. Most men with a mildly raised PSA do not have cancer. It means we should confirm the result and look for the cause.
Could an infection be behind my high PSA?
Yes. Prostatitis and urinary infections can raise PSA for several weeks, which is why we check the urine and may repeat the test after treatment.
Do I need a biopsy?
Not automatically. A repeat PSA, an exam and often an MRI come first, and a biopsy is recommended when those point toward a cancer worth finding.
What does MRI fusion add to a biopsy?
A biopsy guided by your MRI images merged with live ultrasound, so needles are aimed at the areas that looked suspicious.
Is the biopsy painful?
Numbing medicine or light sedation keeps it tolerable, and most men describe soreness for a day or two rather than significant pain.
How often should PSA be checked after a normal result?
That depends on your age, the level and how fast it has changed. Our urologists will set a schedule with you.
Which video explains this?
Watch on YouTube: What is Elevated PSA and how Advanced treats itWhat the video covers: A look at what an elevated PSA means and how our practice approaches it.
Watch: #012 - Prostate Biopsy Demystified: What to Expect and How It Helps
What the video covers: A podcast episode explaining what to expect from a prostate biopsy and how its results help guide care.
Videos open on Advanced Urology's YouTube channel.
Which of our urologists focus on this?
These physicians list it among their focus areas on their Advanced Urology profiles. You can ask for one by name when you book.
- Dr. Michael F. Nordsiek, Lawrenceville: Elevated PSA
- Dr. Nicholas Farber, Braselton: Elevated PSA
Which of our articles go deeper?
Where can you be seen for this?
At the Lawrenceville Clinic & Surgery Center on Crown Pointe Way, where testing and outpatient procedures share one building, or at the Braselton Clinic on Old Winder Highway for visits, lab work and follow-ups. Our Oakwood Clinic is opening soon. Call (678) 344-8900 or book online, and see your first visit and what to bring before you come.
Ready to talk with our urologists? We're here for you.