In my PSA Study, the median PSA value for the age group of men without clinical evidence of prostate cancer is 0.7 for men in their 40s, 0.9 for men in their 50s and 1.4 for men 60 years of age or older.
In any case, I recommend an initial biopsy if the PSA is persistently higher than 2.5 ng/ml.
If the PSA is higher than 4 ng/ml, a PSA velocity higher than 0.75 ng/ml/year should prompt a biopsy, even if a previous biopsy has been negative for cancer.
PSA measurements are best made at least 48 hours after a prostate examination or ejaculation because either can raise the PSA level slightly.
Also, some medicines can affect PSA. Finasteride (marketed as Proscar or Propecia) and dutasteride (marketed as Avodart) can falsely lower PSA levels. Herbal preparations can also affect PSA levels, especially dietary supplements that are advertised “for prostate health.”
Repeated biopsies can actually induce PSA elevations, so once a patient has had adequate biopsy sampling of the prostate, a moratorium on repeat biopsies should be called for one year to allow the prostate gland to heal from all of the previous biopsies.
Bookmarks