Myth 8

Fact: PSA levels can be useful in diagnosing prostate cancer, but they’re only one piece of the larger puzzle. The PSA test is far from perfect. Low PSA readings are similar to negative mammograms in women. If you have a negative mammogram, it's not 100% in terms of excluding cancer. The probability is less, but likewise just because your PSA is relatively low, you can’t interpret that to mean that there is no cancer present.

To get the most complete picture of your prostate health, you need to get other diagnostic tests as well. This may mean getting a biopsy. But that standard is changing. A major study published in The New England Journal of Medicine in March 2018 and The Lancet in February 2017 point to the value of a special type of MRI imaging called multiparametric magnetic resonance imaging, and now the introduction of Prostate Specific Membrane Antigens (PSMA) precision imaging, can provide much greater specificity in the diagnosis and staging of prostate cancer.

“While the biopsy is still the gold standard when it comes to the diagnosis of cancer, this MRI and the PSMA can add localization and help streamline the efficiency of the biopsy. It can tell you where to put the needle and also, in some patients, tell you that a biopsy is not required because the probability of cancer is very low.

Actually, a high PSA (prostate specific antigen) level means you are at increased risk for the disease if it’s being produced as a result of Cancer. A High PSA can occur for nearly a dozen reasons other than the presence of prostate cancer. So, if your doctor says your PSA level is high (which is loosely defined as 4 ng/ml or greater, and some are saying 1.5 ng/mg is the new standard), don’t panic. High PSA levels can be caused by an enlarged prostate, a prostate infection (prostatitis), urinary tract infection, advancing age, recent prostate biopsy, recent use of a catheter, recent bladder test (cystoscopy), ejaculation within the previous 24 to 48 hours, vigorous physical exercise, and riding a bicycle.