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If the results of your DRE are abnormal or your PSA level is high, your doctor may suggest repeating the PSA test or may request an ultrasound, a biopsy, or other tests. The normal range for a PSA test is 0-4 nanograms per milliliter (ng/mL). A result over 10 ng/mL is considered high, and a result of 4-10 ng/mL is considered "borderline high."
If your PSA level is high, the doctor may want to do a biopsy, a procedure in which a small sample of tissue is removed for examination. A borderline PSA test result can be confusing because it does not always indicate the presence of prostate cancer. An elevated PSA level can be caused by other, noncancerous prostate conditions such as benign prostatic hyperplasia (BPH), a type of noncancerous prostate enlargement, and prostatitis, inflammation of the prostate.
If your DRE results are normal but your PSA level is borderline high, your doctor may want to do a transrectal ultrasound (TRUS), a test using sound waves produced by a device inserted into the rectum to produce a picture of the prostate. This ultrasound may identify abnormal areas of the prostate, which can then be biopsied. If the ultrasound is normal, however, you may simply need to repeat the PSA test after a few months. The biopsy is the only way to confirm a diagnosis of prostate cancer.
The following new PSA tests may also help a doctor to evaluate a patient whose initial PSA was borderline high:
Because these tests are new, the medical community has not yet determined when and how the tests should be used. Your physician can help you decide whether any of these tests will be appropriate for you.