High PSA

Last Modified: November 30, 2003

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.

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