DR CHEW-LIN YIP | UROLOGIST
Raised PSA in Perth and Mandurah
What is PSA?
Dr Chew-Lin Yip assesses men with a raised PSA at his consulting rooms in Mandurah, Murdoch and Rockingham, for patients across the Peel region and southern Perth. Most men referred with a raised PSA do not turn out to have prostate cancer. The purpose of the assessment is to work out who needs further investigation and who does not.
PSA, or prostate specific antigen, is a protein made by the prostate and measured in a blood test. It is specific to the prostate, but not to prostate cancer. A raised result means the prostate is producing more PSA than expected. It does not say why.
What can raise a PSA?
• benign enlargement of the prostate, which becomes more common with age
• urinary infection, or inflammation of the prostate
• recent ejaculation
• a recent catheter, cystoscopy or prostate procedure
• prolonged cycling shortly before the test
Prostate cancer can also raise PSA, which is why a persistently raised result is investigated rather than dismissed.
Is there a normal PSA level?
There is no single figure separating normal from abnormal. A result is interpreted alongside age, prostate size, previous results and the rate of change. A modest rise in a man with a large prostate may be expected; the same figure in a man with a small prostate may not be.
How a raised PSA is assessed
Consultation and examination — your urinary symptoms, any family history of prostate, breast or related cancers, and examination of the prostate.
Repeat blood test — PSA fluctuates, so a single raised result is often repeated, sometimes after treating an infection.
MRI of the prostate — a multiparametric MRI identifies areas warranting sampling, and can be reassuring enough to avoid a biopsy in some men.
Prostate biopsy — where indicated, to establish whether cancer is present and how aggressive it appears. See prostate MRI and biopsy.
If cancer is found
Not all prostate cancer needs immediate treatment, and treatment is not always surgery. Depending on the grade and stage, options may include active surveillance, robotic prostatectomy, external beam radiotherapy, whole-gland brachytherapy or focal treatment. Dr Yip offers several of these within the one practice, so the discussion can begin from your diagnosis rather than from a single available technique. See prostate cancer treatment options.