High PSA

Last Modified: November 30, 2003

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Question

Dear OncoLink "Ask The Experts,"
My husbands PSA is 50. A DRE indicated an enlarged and hardened prostate with nodules. A biopsy is scheduled. What are the implications of a PSA of 50? Can I assume from this score that he has cancer and that the cancer has spread? 

Answer

Alan J. Wein, MD, Professor and Chair of the Division of Urology at the University of Pennsylvania School of Medicine, responds:

In the absence of infection, a PSA of 50 generally indicates prostate cancer. Unfortunately, if cancer, this high of a PSA generally indicates advanced disease-- not necessarily metastatic, maybe just advanced local disease. With a physical exam such as the one described, I would say the most likely possibility is prostate malignancy. Have the biopsy done as soon as practical, with ultrasound guidance preferably.