Symptom guide

Your PSA came back high. What happens now?

A phone call or patient-portal message saying your PSA is elevated can stop you in your tracks. Take a breath: an elevated PSA asks for a closer look, and it is not a cancer diagnosis. Here is how our urologists in Marietta, Canton and Jasper help you sort out what the number means.

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What is PSA, in plain words?

PSA, short for prostate-specific antigen, comes from cells in the prostate gland. A little of it leaks into the blood all the time, and the blood test measures how much. Anything that irritates, enlarges or disturbs the prostate can push the number up, and cancer is just one item on that list.

Is a high number the same as having cancer?

No. Most men we see for a raised result turn out not to have cancer. Common reasons for a higher reading include:

An enlarged prostate (BPH), which grows with age
Prostatitis, an inflamed or infected prostate
A recent urinary infection
Ejaculation, a long bike ride or a prostate exam in the day or two before the blood draw
A catheter or a recent urology procedure

Some things can also push the number down, most notably the prostate medicines finasteride and dutasteride. Tell us if you take either one, because we read your result differently.

What number counts as high?

There is no single cutoff that fits every man. A result that is unremarkable at 70 may deserve a closer look at 50, and a number that climbs quickly over a year or two can matter more than one reading on its own. That is why our urologists ask for every PSA result you have ever had, from any lab or doctor.

What happens at my first visit?

A review of your PSA history, family history and urinary symptoms
A prostate exam, which takes less than a minute
Often a repeat PSA, timed to avoid things that skew it
A plan for what comes next, explained before you leave

When is a prostate MRI recommended?

If the repeat test is still raised or the exam raises questions, a prostate MRI shows whether any area of the gland looks suspicious. A clear MRI can sometimes spare a man a biopsy; a spot that stands out helps aim one.

What is a prostate biopsy like here?

When a biopsy is the right step, our urologists do it at one of our surgery centers with anesthesia, so you sleep through it, and a fusion technique lines up your MRI images with ultrasound during the procedure. Expect some soreness and a little blood in urine or semen for a short time afterward. We call you with results and talk through them together.

And if cancer is found?

Many prostate cancers grow slowly. For lower-risk cancers, our urologists often recommend active surveillance, steady monitoring instead of immediate treatment. When treatment is the better choice, options include robotic prostate surgery and radiation, and our prostate cancer page explains them. Dr. Jason Lomboy, who sees patients in Marietta, Canton and Jasper, focuses on elevated PSA and prostate cancer care.

When should I book?

Book a visit if your PSA is above the range your doctor flagged, if it has risen noticeably since the last test, or if a close male relative was diagnosed with prostate cancer. Waiting months for another routine check usually just stretches out the worry. Our high PSA and biopsy page covers the testing in more depth.

Where can I be seen for this?

Marietta Clinic & Surgery Center, 1371 Church Street Extension NW, Marietta, GA 30060. Seen here for this concern: Jason Lomboy, MD, Daniel Roberson, PA-C, Amanda Boulos, PA-C, Ionela Turcin, PA-C, Britany Howard, FNP. Procedures for all four offices happen in this building.
Canton Clinic, 2205 Riverstone Blvd Suite 101, Canton, GA 30114. Seen here for this concern: Jason Lomboy, MD, Daniel Roberson, PA-C, Amanda Boulos, PA-C, Ionela Turcin, PA-C. Procedures are scheduled at our Marietta Clinic & Surgery Center.
Dallas Clinic, 2713 Charles Hardy Parkway, Bldg 100, Suite 122, Dallas, GA 30157. Seen here for this concern: Daniel Roberson, PA-C. Visits here are with Daniel Roberson, PA-C. Physician visits and procedures are arranged in Marietta.
Jasper Clinic, 49 Gordon Rd Suite 103, Jasper, GA 30143. Seen here for this concern: Jason Lomboy, MD, Britany Howard, FNP. Procedures are scheduled at our Marietta Clinic & Surgery Center.

Jason Lomboy, MD, Advanced Urology — Jason Lomboy, MD

Daniel Roberson, PA-C, Advanced Urology — Daniel Roberson, PA-C

Amanda Boulos, PA-C, Advanced Urology — Amanda Boulos, PA-C

Ionela Turcin, PA-C, Advanced Urology — Ionela Turcin, PA-C

Britany Howard, FNP, Advanced Urology — Britany Howard, FNP

Questions people ask us

Should I repeat the PSA before seeing a urologist?

You can come straight to us. We often repeat it ourselves, timed so that recent exercise, infection or ejaculation doesn't skew the result.

Can an infection raise PSA?

Yes. A urinary or prostate infection can push PSA up for weeks, so we may treat the infection and then recheck.

Do I have to have a biopsy?

No. A biopsy is a choice we make together, guided by your repeat PSA, exam and often an MRI.

Is the biopsy done in the office?

No. Our urologists do prostate biopsies with anesthesia at our surgery centers rather than in an exam room, so you're asleep.

I'm in Dallas. Where would I be seen?

Daniel Roberson, PA-C, at our Dallas Clinic sees men for elevated PSA. When a urologist visit, MRI follow-up or biopsy is needed, that care is arranged in Marietta.

Does a normal PSA mean I'm in the clear forever?

It is reassuring for now. PSA is rechecked over time, at intervals based on your age, family history and whether the number is rising.

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Other symptoms we help with

Educational information, not medical advice or a diagnosis. Every treatment has risks, benefits and alternatives to discuss with your clinician.