Men often worry that an elevated PSA means they may have prostate cancer. Fortunately, only 25-30 percent of men with a PSA between 2.5 and 10 will be diagnosed with prostate cancer, and the majority of those men will have very early-stage cancer.

While some criticize PSA screening, it's important to know that prostate cancer deaths have declined 44 percent since it was introduced in 1991. Today, it continues to remain the best way to detect prostate cancer.

The PSA is a simple blood test that measures the amount of a specific protein—prostate-specific antigen (PSA)—in a man’s bloodstream. PSA is a protein molecule produced not only by prostate cells, but also by prostate cancer cells. PSA protein should remain in the prostate and within ejaculate where it helps liquefy semen and break down other proteins to help sperm live longer after a man ejaculates. A small number of PSA molecules can leak into the bloodstream, but when a PSA level is higher than normal, it may be a sign of something more serious happening in the prostate.

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There continues to be a debate about “normal” PSA levels. For men under the age of 60, PSA levels should be below 2.5. For men over 60, PSA levels may rise slightly, but not indicate the presence of cancer. Ideally, PSA levels should be below 2.5. If it rises above this level, it should warrant close follow-up, or, at the very least, a referral to a urologist. While a PSA level greater than 2.5 does not mean a man has prostate cancer, it does mean the level warrants further investigation to see if it remains elevated.

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There are several situations that can lead to a falsely elevated PSA and should be considered before having blood drawn for a PSA test. Men should delay having a PSA test if they have painful urination or a urinary tract infection, engaged in sexual activity with the last 24 hours, or undergone a cystoscopy, catheter insertion or other urinary instrumentation.

Several other factors can cause an elevated PSA, including a man’s age (the prostate naturally grows over time), an enlarged prostate and inflammation of the prostate (with or without symptoms). A simple digital rectal exam (DRE) in the office should not cause any significant rise in PSA. This has been studied extensively, so don’t worry about getting a PSA after a DRE.

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The PSA molecule circulates throughout the body in two forms—either bound to other proteins or unbound. The free PSA measures the unbound molecule and is often used by urologists as another helpful indicator for prostate cancer. The lower the percent of free PSA, the higher the risk of having prostate cancer. Patients with free PSA of less than 10 percent can have up to a 56 percent risk of harboring a focus of cancer in their prostates.

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Prostate cancer is known as the silent killer because it rarely exhibits any early warning symptoms such as pain or blood in the urine. When prostate cancer becomes metastatic (migrates beyond the prostate and into the bones), it is incurable. Yet, when it is found early, many types of prostate cancer can be followed closely and be effectively treated.

The five-year survival rate for men with local or regional prostate cancer is 100 percent. The five-year survival rate for men diagnosed with metastatic prostate cancer at their original diagnosis is only 30 percent. Urology Partners wants men to know that we have your back on this one. Not every man needs treatment, but the ones who do should get it early before they become another cancer statistic.