Testing a man’s PSA level is the most common method of evaluating the chances of prostate cancer. I remember when the only way to routinely check for prostate cancer was the infamous digital rectal probe. I always dreaded my annual physical knowing that sooner or later I had to drop my pants, bend over, and assume the position. The goal of the exam is to feel the prostate for lumps or bumps that may indicate a possible tumor. Truth be told, the doctors didn’t care much either. In fact, I had a doctor who never in the many years that I was his patient performed the procedure. Shame on him and me for not insisting on the exam.

So when I found out that a new test had been approved, requiring a simple blood test, I was happy. He would no longer have to “take office”. However, I must point out that the digital test is still used and is a viable test that should be used in conjunction with the PSA blood test.

However, there is a major problem with testing for PSA levels and that is false positives. False positives occur when, for various reasons, you have a high PSA level but do not have cancer. There are several reasons for a high PSA that have nothing to do with cancer. Certain medications such as finasteride and dutasteride can increase PSA. Also, UTIs can cause a rise in PSA. Even different laboratories can give different results.

PSA is a double-edged sword that, on the one hand, can detect evidence of prostate cancer, but on the other hand, a false positive could mean that a man could undergo a prostate biopsy unnecessarily. There is even a lot of debate about the frequency of testing, at what age testing should begin, and what is an acceptable PSA level above which a person should undergo further testing.

In my case I went to the middle ground. When my test results showed an increase in my PSA above 4.0, after consulting with my doctor, I decide to wait (Watchful waiting) three months and then do another PSA test. Unfortunately for me, my PSA continued to rise and I had a biopsy that checked for cancer.

The bottom line here is to know about these tests and consult with your doctor. Because prostate cancer is in most cases a slow-growing type of cancer, you don’t need to make immediate decisions. I would encourage anyone with a PSA level above 4.0 to wait three months and re-test. However, an extremely high PSA could indicate advanced cancer. It is important to have regular checkups and PSA tests to establish a baseline for you and your doctor.