Elevated PSA

Elevated PSA

What is the PSA test?

Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood.

The blood level of PSA is often elevated in men with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, the FDA approved the use of the PSA test in conjunction with a digital rectal exam (DRE) to test asymptomatic men for prostate cancer. Men who report prostate symptoms often undergo PSA testing (along with a DRE) to help doctors determine the nature of the problem.

In addition to prostate cancer, a number of benign (not cancerous) conditions can cause a man’s PSA level to rise. The most frequent benign prostate conditions that cause an elevation in PSA level are prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH) (enlargement of the prostate). There is no evidence that prostatitis or BPH leads to prostate cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.

Is the PSA test recommended for prostate cancer screening?

Until about 2008, some doctors and professional organizations encouraged yearly PSA screening for men beginning at age 50. Some organizations recommended that men who are at higher risk of prostate cancer, including African American men and men whose father or brother had prostate cancer, begin screening at age 40 or 45. However, as more was learned about both the benefits and harms of prostate cancer screening, a number of organizations began to caution against routine population screening. Most organizations recommend that men who are considering PSA screening first discuss the risks and benefits with their doctors.

Currently, Medicare provides coverage for an annual PSA test for all Medicare-eligible men age 50 and older. Many private insurers cover PSA screening as well.

What is a normal PSA test result?

There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.

However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer (1). In addition, various factors can cause a man’s PSA level to fluctuate. For example, a man’s PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugs—including finasteride and dutasteride, which are used to treat BPH—lower a man’s PSA level. PSA level may also vary somewhat across testing laboratories.

Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of white men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.

In general, however, the higher a man’s PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a man’s PSA level over time may also be a sign of prostate cancer.

What if a screening test shows an elevated PSA level?

If a man who has no symptoms of prostate cancer chooses to undergo prostate cancer screening and is found to have an elevated PSA level, the doctor may recommend another PSA test to confirm the original finding. If the PSA level is still high, the doctor may recommend that the man continue with PSA tests and DREs at regular intervals to watch for any changes over time.

If a man’s PSA level continues to rise or if a suspicious lump is detected during a DRE, the doctor may recommend additional tests to determine the nature of the problem. A urine test may be recommended to check for a urinary tract infection. The doctor may also recommend imaging tests, such as a transrectal ultrasoundx-rays, or cystoscopy.

If prostate cancer is suspected, the doctor will recommend a prostate biopsy. During this procedure, multiple samples of prostate tissue are collected by inserting hollow needles into the prostate and then withdrawing them. Most often, the needles are inserted through the wall of the rectum (transrectal biopsy). A pathologist then examines the collected tissue under a microscope. The doctor may use ultrasound to view the prostate during the biopsy, but ultrasound cannot be used alone to diagnose prostate cancer.

~ Source Mayo Clinic

Joel LemkeJoel Lemke
19:42 28 Jan 24
jeffrey halselljeffrey halsell
16:33 28 Jan 24
Dr. Zafar and his team did an amazing job! They made me feel comfortable throughout the whole process. He was very professional and detailed oriented about everything before, during and after the procedure and even took the time to contact to check up on me personally. I highly recommend him and his staff!!
Wyatt KelsoWyatt Kelso
18:52 22 Jan 24
Matt SepanskiMatt Sepanski
01:59 22 Jan 24
Dr. Zafar is very friendly, professional, and knowledgeable. He’s been very good about following up with me to check on me and make sure I’m doing well after my surgery. I would highly recommend him.
Brooke HallBrooke Hall
17:56 08 Jan 24
Dr. Zafar is personal, kind, answers all your questions, listens to you and has a great staff. Highly recommend if you need help in this area.
Lawrence OkpakoLawrence Okpako
03:19 08 Jan 24
Aaron SchmidtkeAaron Schmidtke
20:53 07 Jan 24
Great experience all the way through. Staff was friendly and helpful. The process was quick and painless. All the recovery tips helped immensely with a pain free recovery.
alvaro delunaalvaro deluna
20:06 07 Jan 24
Todd CowmanTodd Cowman
17:52 30 Dec 23
Dr. Zafar and staff provided exceptional care and education. It’s a small office but from initial call to visit and follow up I couldn’t have imagined a better experience. Experts at their craft. Trust the 5 star reviews.
Dave RogersDave Rogers
19:20 26 Dec 23
Excellent health care and caring
Dan Van LangenDan Van Langen
23:31 21 Dec 23
jodi sindtjodi sindt
22:09 19 Dec 23
Dr Zafar has made me a better person I have dignity & overall self esteem after years of embarrassing issues with incontinence he recommended I stop caffeine intake In one month my life has turned around thank you forever Dr Zafar
James RubleJames Ruble
00:00 18 Dec 23
Dr. Zafar and his team are welcoming, professional and compassionate. I especially appreciate the fact that they were able to tell me exactly what the services would cost before even scheduling an appointment.
Joe BrookoverJoe Brookover
23:55 17 Dec 23
Very much enjoyed working with Dr. Zafar. He was very helpful in explaining the procedure and steps after, and is incredibly personable. Would highly recommend.Update following procedure: Dr. Zafar and his team provided excellent care. I’m currently 4 days post-op and feel nearly back to normal. During the procedure he explained what was happening and helped by chatting about a variety of topics to keep my mind off what was happening below the curtain. The care instructions provided have given me a great guide to recovery. There are no shortcuts- just follow what he says to do and you’ll be back on your feet in a few days!
Lynn CarricoLynn Carrico
17:38 16 Dec 23
Everyone was professional and caring. They explained what they were doing in a way I could understand.
Lew KirkLew Kirk
18:17 13 Dec 23
Timely, efficient and effective. Dr Zafar and the staff are a pleasure to work with. Highly recommended for urology concerns.
Jacob SpjutJacob Spjut
02:59 12 Dec 23
I can’t recommend enough. Not only professional, but quick. A masterful execution of the procedure.
Luann SechristLuann Sechrist
13:32 10 Dec 23
Dr. Zafar and his team is one of the best! I cannot Express the compassion him an his staff always have for me. I have been going to Dr. Zafar for well over 10 years, and never one issue or complaint. Best urologist around. You are always in the best hands with him!!
Twan PortisTwan Portis
21:39 04 Dec 23
Mike SchakelMike Schakel
20:33 04 Dec 23
Dr. Zagar is a very professional, knowledgeable and kind urologist. I would recommend him to anyone.
anthony chiaanthony chia
19:38 04 Dec 23
I truly appreciate my visits with dr.zafar. He has always been professional and no hesitation to check everything. No corners skipped.
Adam HuddleAdam Huddle
22:28 03 Dec 23
Tanner SteinhoffTanner Steinhoff
22:06 03 Dec 23
Dr. Zafar and his staff are great. Very thorough and efficient. I highly recommend.
Edwin DornEdwin Dorn
21:46 03 Dec 23
The doctor was great. He was very Informative . I was in and out in minutes
Anthony AdamsAnthony Adams
07:31 01 Dec 23
Jerry MeredithJerry Meredith
00:57 30 Nov 23
Very informative of questions and explanation of situations, takes time to listen to patients promblems and concerns then offers advice or solutions. I would recommend Dr for your treatments.Thank you
Jerry MeredithJerry Meredith
18:37 28 Nov 23
Phil DoakPhil Doak
16:29 28 Nov 23
Dr Zafar is very kind, knowledgeable, and respectful. Highly recommend!
Rob ERob E
22:47 21 Nov 23
Dr. Zafar has been following my condition for several years now and has performed a very successful TURP surgery two years ago. I am doing quite well under his care. All questions are fully answered and adequate time is given me when I am at the clinic in Centerville, so that I feel all issues are covered.
MinaMina
21:05 20 Nov 23
Jason BuckJason Buck
13:06 20 Nov 23
It’s crazy how little discomfort I have after my procedure! Dr Z was great before, during and after. The nurses were so nice and made me feel very comfortable too. Overall very happy with the entire experience.
Lexy DetermanLexy Determan
01:33 20 Nov 23
I’ve been beyond pleased with the service and attention I’ve received through Dr. Zafar and his office. I was extremely nervous, and frankly a little embarrassed to talk about the issues I was having with incontinence. That was quickly put to rest by everyone I interacted with. I am so happy I finally went through with this process!
Ryan ReynoldsRyan Reynolds
01:17 20 Nov 23
Excellent service. Dr. Zafar is great.
Brad PetersBrad Peters
16:02 10 Nov 23
James MoncherryJames Moncherry
02:55 09 Nov 23
5 Star Service and Professionalism!Upon entering Lakeview Center For Urology, I was warmly greeted by the front office staff, swiftly brought into a room and had vitals taken by a clinician.I was professionally greeted and had a very thorough discussion on my concerns with Dr. Zafar!I will be a returning patient when in need and referring friends and family alike to him and his clinic.This was a tremendous experience!
Patrick HolterhausPatrick Holterhaus
20:05 08 Nov 23
Very nice office, kind assistance from nurse/Dr. No complaints!
Troy HobscheidtTroy Hobscheidt
19:28 08 Nov 23
Dr. Zafar is one of the most informative, professional and thorough doctors that I have seen in my adult life. He used language that was very easy to understand. He went out of his way to accommodate me to complete this procedure. I look forward to working with him during my follow care. I would DEFINITELY recommend Dr. Zafar.
JOHN HARRISJOHN HARRIS
17:51 08 Nov 23
Very knowledgeable and detailed. Highly recommend.
Alex LevequeAlex Leveque
17:06 08 Nov 23
Good and clear information, honest and straightforward. Understanding of financial/insurance concerns and adaptive in response to personal concerns.
Nick SmithNick Smith
02:15 07 Nov 23
Dr. Zafar was great, gave me all the information I needed. As well as the rest of the staff was great.
Kenneth JonesKenneth Jones
19:03 06 Nov 23
Was very helpful an Respectful doctor
Jacob & Samantha SpjutJacob & Samantha Spjut
16:36 06 Nov 23
Russell MentzerRussell Mentzer
11:56 05 Nov 23
Christopher GallantChristopher Gallant
23:56 04 Nov 23
James TJames T
16:43 03 Nov 23
Dr Zafar was very comforting and knowledgeable, the procedure was quick with minimal pain. I would highly recommend his office to anyone!
Michael ScottMichael Scott
18:46 01 Nov 23
Bob McFarlandBob McFarland
18:43 01 Nov 23
I recently moved to the Des Moines area and needed to find a urologist. Dr. Zafar was recommended by my primary care physician. Dr Zafar thoroughly reviewed records from my old urologist prior to my appointment and made good recommendations regarding additional care.
R BerklandR Berkland
18:07 01 Nov 23
Pain free and worry free vasectomy today. Dr. Zafar is excellent and I'd highly recommend his methodology for the procedure. I was worried for nothing.
Cj DavisCj Davis
16:32 01 Nov 23
Joe BarthelJoe Barthel
15:01 31 Oct 23
Best urologist in the city always cares about his patients. Is always there when you need him. Best caring staff always makes time when needed. I have recommended him to several people that have had bad experiences and they love him. He has been there for me on three different kidney stone episodes didn’t matter time day or night he made time some way to be there. Will never change doctors. Never had an appt problem or billing problem. His staff is well trained and keeps everything on time thank you . Total rating is 5 with 5 being the top rating.
David KohlerDavid Kohler
01:23 26 Oct 23
My first appt with Dr. Zafar was very informative on what steps that needed to be taken to further help me with understanding and correcting my issues!The office staff was also helpful with all the information I needed and scheduling appointments for further examinations.So far ?
Austin OlsonAustin Olson
21:35 21 Oct 23
Great experience overall. Was able to book appointment and have procedure within 2 weeks compared to other places which take 2-3 months and a lot of back & forth. Staff was friendly and Dr. Zafar is very professional, knowledgable and keeps you at ease. Highly recommend.
Ben ParryBen Parry
16:57 08 Oct 23
Dr. Z and staff were very kind and helpful. The procedure went quick and painless. I continue to be pain free 4 days later. Highly recommended!
Nathan GarnseyNathan Garnsey
14:45 06 Oct 23
Jackie HarrisJackie Harris
19:29 02 Oct 23
Would highly recommend Dr. Zafar, he and his office made the entire vasectomy process as simple and painless as possible
Taylor FoxTaylor Fox
22:40 29 Sep 23
Ghazanfar GujarGhazanfar Gujar
16:30 29 Sep 23
Excellent service
Amy O'BrienAmy O'Brien
03:58 24 Sep 23
Everyone in the office is super kind and professional. Dr. Zafar was patient and has a great bedside manor. He covered various treatments to get to the root of the problem. Highly recommend!
Eric MurphyEric Murphy
19:14 26 Aug 23
Dr. Zafar and his staff were very welcoming, helpful and informative during my experience. Next day follow is always reassuring and appreciated. I highly recommend this office for a Vasectomy in the metro area.
Peter SeehusenPeter Seehusen
23:49 22 Jul 23
I had a Vasectomy done by Dr. Zafar. Was nervous about getting it done but it was a great experience. No pain at all!They emailed me the paperwork ahead of time. My appt was 1:20pm, I got in on time and I was leaving by 2pm! Friendly and helpful staff. Dr. Zafar was very nice, competent and very approachable with questions. Dr. Zafar personally called the next day to follow up even. Highly recommend the Lakeview Center!!
Hannah WarnerHannah Warner
23:50 11 May 23
The compassion, kindness, and care of Dr. Zafar, Amanda, and team went beyond any expectation we had for our healthcare needs. There aren’t words to express our gratitude. Dr. Zafar takes his time to listen and clearly explains potential pathways and education on conditions. The peace of mind our visit with Lakeview provided is invaluable. If you’re ever in need of urological care, Dr.Zafar and his team are truly rare in their compassionate care for their patients and I highly recommend them. Special thanks to Amanda, she is an incredible human with the biggest, kindest heart! ❤️
JakeJake
15:46 09 Feb 23
I chose Lakeview Urology based on the reviews and they don’t lie. The team was very supportive and comforting during the entire process and follow up. Dr. Zafar cares about his patients, the quality of the procedure, and goes out of his way to follow up to ensure your recovery goes smoothly. I highly recommend Dr. Zafar and his team.
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