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PSA level query

Posted 15 Jun 2021 at 15:25

Hi Guys, I have just been informed after receiving my second set of PSA results today my PSA level is 4.3

(six weeks ago it was 3.9) 

My Dr has put me in for a MRI scan.

I am 41 years old - fit and healthy.  (I tend to drink two cups of coffee per day.)  No pains.  Just delayed urination and sometimes cant wait to urinate. No night interruptions.  

Should I be worried?  

Posted 15 Jun 2021 at 16:36

Hi Aman1699, the NICE guidelines say that a PSA up to 4 is normal but recommends checking if it is above 3 so your doctor is right to ask for a scan. Did the doctor do a DRE? 
Hopefully nothing to worry about but correct to check it. See NICE guidelines below

How should I interpret and manage PSA results?

  • A normal prostate-specific antigen (PSA) level ranges from 0–4 nanograms/mL. However, the upper level of normal may vary according to age and race, and the PSA test is not diagnostic. 

    • Men with an elevated PSA may need further investigation, for example a biopsy.

  • If the prostate-specific antigen (PSA) level in men (of any race) aged 50–69 years is:

    • 3.0 nanogram/mL or higher — refer men urgently using a suspected cancer pathway referral (for an appointment within 2 weeks) to a specialist. 
    • Within the normal range for this age group (that is lower than 3.0 nanograms/ml) — there is a low risk of prostate cancer. 

      • Refer only if there are other concerns, for example factors that increase the risk of prostate cancer, or an abnormal digital rectal examination (DRE).

  • Clinical judgement should be used to manage symptomatic men and those aged under 50 who are considered to have a higher risk for prostate cancer.


Posted 15 Jun 2021 at 18:19
An elevated PSA level is grounds for investigation. There are many possible causes. Wait and see.

Best wishes,


Posted 16 Jun 2021 at 09:35

My  PSA level in 2018 (when I was 60) was 3.58 and when it was tested again on 10/03/21 it was 5.32. A further test on 12/04/21 found that my PSA had increased to 5.76. I was, as a consequence, booked in for an MRI scan and when that showed a 1.5 cm lesion in my prostate I was then booked in for a biopsy on my prostate. Fortunately, the biopsy results show that my cancer is very slow growing and it is likely that no action will be taken at this time. The point I am trying to make is that it is certainly worth getting checked out so that things can be ruled out and so, if necessary, early effective action can be taken.

My consultant told me that 1 in 5 men over 40 have prostate cancer, that most men over 60 have it and that all men 80 & over have it.  Thirty or more years ago men were not tested and many had it without knowing. For most men, you are more likely to die of something else rather than of prostate cancer.

As mentioned by Ian & Chris, there are all sorts of reasons for a slightly elevated PSA and your PSA level is still very low. Bob Monkhouse's (game show host/actor/writer/comedian)  PSA level was well over 1300 when he was tested back in 2002.

Let us know how you get on with the MRI scan


Posted 16 Jun 2021 at 10:20

Originally Posted by: Online Community Member
My consultant told me that 1 in 5 men over 40 have prostate cancer

He's wrong, it's 2 in 5 men at age 40, and much higher if you include all men over 40.

It's easy to remember:
40% of 40 year olds have it;
50% of 50 year olds have it;
60% of 60 year olds have it;
70% of 70 year olds have it;
80% of 80 year olds have it.

Of course, most of these men will never know and never need treating. The important thing is to catch those who will need treating.

Posted 16 Jun 2021 at 11:33

The question I wonder about  whatever % is used is how do they know for sure? Obviously, not every 40 year old is tested so it must be based on a random sample that is then extrapolated to give rise to the often quoted numbers.

Another "interesting" fact that I came across is that a slow growing prostate cancer cell takes over 400 days to form; so a 1 cm lesion could well be over 40 years old. Furthermore, Japanese research has found that the prostates of some guys in their late 20's/early 30's when sampled are already showing signs of slightly irregular cell formation. Nature's way perhaps of saying these guys have done their job (i.e. father babies) so I have no use for them now.

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