Elevated PSA

We know an elevated PSA test result can be alarming. If you have an elevated PSA, the urologists at Hackensack Meridian Health are here to help. Our experts can guide you through the next steps, determine your risk for prostate cancer and if you should have further testing.

The Prostate Specific Antigen Blood Test

Prostate-specific antigen (PSA) is a protein secreted by the prostate gland. A number of conditions, including prostate cancer, can cause a PSA level to rise. Our urologists are experts in using the PSA blood test as a screening tool for prostate cancer and will discuss if the PSA test is right for you. 

There is no “normal” PSA level. In the past, urologists considered 4 ng/mL or greater as elevated. However, our doctors take into consideration additional factors, such as your age, family history, previous PSA levels and other health conditions when deciding if your PSA level is a concern.

An elevated PSA does not mean you have prostate cancer. Other conditions that can cause a rise in PSA include: 

  • Infection or inflammation of the prostate gland, known as prostatitis
  • Enlarged prostate, also known as benign prostatic hyperplasia (BPH)
  • Recent urinary catheter placement
  • Urinary tract infection

You may be at increased risk for prostate cancer if you: 

  • Are between the ages of 55 - 70
  • Have a family history of prostate cancer
  • Are of African American descent

Men who are experiencing prostate problems typically have elevated levels of PSA, along with other symptoms, including:

  • Frequent or urgent urination
  • Difficulty getting a urine stream going
  • Feeling as though you are unable to empty your bladder completely
  • Pain when urinating or ejaculating
  • Fever and chills
  • Pelvic pain
  • Cloudy urine

An Accurate Diagnosis

The PSA test alone cannot be used to diagnose prostate cancer. If your PSA level is elevated, we may recommend one or more of the following tests.

Biomarker tests can help determine if your elevated PSA may be caused by prostate cancer and if a biopsy is necessary.

  • Prostate Health Index (PHI) is a combination of three blood tests (free PSA, total PSA, (-2) pro-PSA isoform (p2PSA)) that can clarify your PSA value.
  • The 4Kscore blood test analyzes four biomarkers (total PSA, free PSA, intact PSA, human kallikrein 2 [hK2]) and gives us a probability score for finding prostate cancer.
  • The PCA3 test detects levels of genetic material in your urine that can indicate the probability of finding prostate cancer.

Our urologists will explain your evaluation plan and any additional tests, including:

  • Physical exam
  • Additional blood and urine tests
  • Cystoscopy to view inside the bladder, performed under local anesthesia in a safe and painless way




High-resolution MRI has been a game changer for diagnosing prostate cancer and preventing unnecessary biopsies.

Hackensack Meridian urologists have led at the forefront as imaging technology for prostate cancer has advanced. Compared with other MRI technology, our 3 Tesla (3T) MRI is unmatched in creating detailed, 3D images of the prostate.

Our 3T MRI makes a difference by allowing your care team to:

  • Determine with great precision the size and stage of any tumors in the prostate.
  • Distinguish low-risk tumors that are candidates for active surveillance without biopsy.
  • Identify more aggressive tumors for biopsy and treatment.
  • Detect any cancer that has spread beyond the prostate.
  • Fuse high-resolution, 3D images with ultrasound for precise biopsy.

A Safe and Precise Prostate Biopsy

MRI-Targeted Fusion Biopsy

Following PSA blood, biomarker and imaging tests, your doctor may recommend a biopsy of small tissue samples from your prostate. Hackensack Meridian Health is the first center in the area to offer MRI-targeted fusion biopsy. This advanced approach combines real-time ultrasound and MRI images for exceptional accuracy.  Advantages of MRI-targeted fusion biopsy at Hackensack Meridian Health include:
  • The safest and most accurate biopsy available.
  • A team highly experienced in this approach.
  • Takes about 30 minutes in an outpatient clinic. You go home after the procedure.
  • Biopsy performed through the perineum (skin between the scrotum and anus) to significantly reduce your risk of infection.
  • Your biopsy samples are analyzed by our expert prostate cancer pathologists.
  • Proven to increase the detection of aggressive prostate cancer, compared to traditional biopsy.

Our urologists are pioneers in MRI-targeted fusion biopsy for prostate cancer. In the last decade, we have performed more than 1,500 MRI-targeted biopsies and have published and presented our outcomes at national conferences. Through a collaboration with other leading institutions, we continue to track patient outcomes to advance the science for you. 

Elevated PSA & Prostate Cancer: Department of Urology at HackensackUMC

"We have the ability to offer new technologies which only a few institutions in the state of New Jersey have."

Dr. Kevin Basralian, M.D., FACS

Leaders in Prostate Cancer Treatment

If the diagnosis is prostate cancer, you’ll find expert care from the team at the John Theurer Cancer Center at Hackensack University Medical Center. Our specialists provide you with the most advanced, proven and effective treatment with the fewest possible side effects

Learn more about prostate cancer care at John Theurer Cancer Center

Our Doctors

Our award-winning team of renowned surgeons, physicians, researchers and specialists provide you with exceptional urological expertise, backed by the latest advancements and technology, to develop a highly personalized plan for each and every one of our patients.

Why Choose Hackensack Meridian Health for Urology Care

Quality

Hackensack University Medical Center has been ranked the #1 Urology Department in New Jersey for eight years in a row by U.S. News & World Report and is the only urology department in New Jersey that is nationally ranked.

Innovation

Our urologists present their clinical research at national conferences and have published over a dozen original studies in peer reviewed journals in a variety of subspecialties. 

 

Patient Experience

We collaborate with physicians throughout our world class health network and partner with Magnet® recognized nurses to provide patients with the most advanced and compassionate care. 

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