High PSA and prostate biopsy: what happens next
A PSA result that comes back higher than expected is a reason to look further, not a diagnosis. Many men are sent to our Marietta, Canton, Dallas and Jasper offices for exactly this, and most of them do not turn out to have cancer.
What can raise a PSA level?
PSA is measured with a blood test. Cancer is one cause of a higher number, but an enlarged prostate (BPH) or an inflamed prostate can raise it as well. That is why our urologists read the result together with your age, your earlier numbers and an exam.
When should you see a urologist about PSA?
Book a visit when a primary care clinician suggests follow-up, when your number has crept up over several tests, or when an exam found a change in the prostate. Bring earlier PSA results if you can find them.
How do our urologists evaluate a high PSA?
The workup moves one step at a time, and each step decides whether the next is needed.
- A repeat PSA, read in context
- A digital rectal exam to feel for changes
- Prostate MRI to show any area that deserves a closer look
- A targeted biopsy when the picture calls for one
- Genomic testing of biopsy tissue in some cases, to help judge how aggressive a cancer is
What is a transperineal MRI fusion biopsy?
It is the biopsy method our urologists use. Your MRI is combined with live ultrasound to build a 3D map, so the needle can be aimed at areas that looked suspicious. The needle passes through clean skin behind the scrotum rather than through the rectum, which lowers the risk of infection.
What is recovery like after a biopsy?
Biopsies are done under anesthesia in our surgery centers, so you are asleep for the procedure. Some soreness or discomfort can follow, and you will leave with written instructions on what to expect and when to call us.
What happens after the results come back?
If no cancer is found, we plan how to keep an eye on your PSA. If cancer is found, its grade and volume guide the choice between active surveillance and treatment, explained on our prostate cancer page and in Dr. Jason Lomboy's active surveillance article.
Elevated PSA on advancedurology.com
Educational information, not medical advice.
More questions we hear
Does a high PSA mean I have cancer?
No. An enlarged or inflamed prostate can raise PSA too, and most men referred to us for a raised number do not turn out to have cancer.
Should the test be repeated?
Often, yes. A single result is read alongside your age, earlier numbers and an exam, and a repeat test is a common first step.
Will I need a biopsy?
Not always. Your history, exam and prostate MRI help decide whether a biopsy is the right next step.
Am I awake for the biopsy?
No. Our urologists perform prostate biopsies under anesthesia in our surgery centers, so you are asleep. Some soreness afterward can happen.
What is PSMA PET/CT?
A scan using a tracer that attaches to prostate cancer cells, which shows whether cancer has reached lymph nodes or bone. It is used for staging higher-risk cancer and when PSA rises after treatment.
Can I bring results from another practice?
Yes. Earlier PSA results, MRI reports and biopsy reports all help us read your current number.
Which articles go deeper on high psa and prostate biopsy?
These short reads answer questions patients often bring to us.
All 1 articles on psa and prostate biopsy
Clinicians whose Advanced Urology profiles list this area: Jason Lomboy, MD, Daniel Roberson, PA-C, Amanda Boulos, PA-C, Ionela Turcin, PA-C, Britany Howard, FNP.
Videos from Advanced Urology
Videos play here from Advanced Urology’s YouTube channel, using YouTube’s privacy-enhanced mode.
Noticing symptoms? Our plain-language guide, Your PSA came back high. What happens now?, explains what to do next.
Treatment and doctors
Let's sort this out together. Our offices in Marietta, Canton, Dallas and Jasper share one phone line and one caring team.