PSA, Total

PSA (Prostate-Specific Antigen) is a protein made by the prostate gland that can be measured with a simple blood test. Higher-than-normal PSA levels can be caused by a variety of conditions, including an enlarged prostate, prostate infection, or prostate cancer, so an elevated result does not automatically mean cancer is present. Your doctor will consider your age, medical history, and other test results together before recommending any next steps. If you have been treated for prostate cancer, PSA is used to monitor how well treatment is working. Decisions about PSA screening are best made through an open conversation with your healthcare provider about your individual risks and preferences.

When elevated: Elevated total PSA warrants clinical correlation and may prompt further evaluation including digital rectal examination, repeat PSA testing, free/total PSA ratio, and consideration of prostate biopsy or advanced imaging. Persistently elevated or rapidly rising PSA increases the probability of prostate cancer, though benign etiologies must be systematically excluded. In men with known prostate cancer, rising PSA after definitive therapy (biochemical recurrence) signals potential disease progression. When low: Low or undetectable PSA levels are generally reassuring in the context of prostate cancer screening and are expected following successful radical prostatectomy. Very low PSA may also be observed in men on 5-alpha reductase inhibitors (e.g., finasteride, dutasteride), which suppress PSA by approximately 50%, necessitating adjusted interpretation thresholds. Low PSA does not entirely exclude prostate cancer, particularly high-grade disease.

PSA is not specifically relevant to athletic performance or training recovery. However, athletes should be aware that intense endurance exercise, cycling, or recent urological procedures can transiently elevate PSA, potentially confounding screening results—timing blood draws several days after strenuous activity or prostate trauma is advisable.