{"id":3058,"date":"2021-05-07T08:00:00","date_gmt":"2021-05-07T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=3058"},"modified":"2026-08-25T22:44:50","modified_gmt":"2026-08-25T15:44:50","slug":"que-faire-en-cas-de-psa-eleve","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/fr\/2021\/05\/07\/what-should-you-do-if-high-psa\/","title":{"rendered":"A High PSA Result: What It Means, and What to Do Next"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/fr\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" 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1.732 0 0 1-.064.262c-.13.523-.402.913-.815 1.17-.413.255-.95.382-1.61.382z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/orcid.org\/0009-0004-8387-3559\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">PSA appears in most health-check packages sold to men over a certain age, which means a great many men receive a raised result having never actually decided to be screened for prostate cancer. They arrive in clinic frightened, holding one number.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That number is not a diagnosis. It is a starting point, and quite often it turns out to mean very little.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"3070\" data-permalink=\"https:\/\/drsoaraweeurology.com\/fr\/2021\/05\/07\/what-should-you-do-if-high-psa\/psa-blood-test\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/PSA-blood-test.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;Freepik Company S.L. - www.freepik.com&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"PSA blood test is the most popular way for screening prostate cancer.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;PSA blood test is the most popular way for screening prostate cancer.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/PSA-blood-test.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/PSA-blood-test.jpg?resize=800%2C533&#038;ssl=1\" alt=\"Blood sample being taken for a PSA test as part of a routine health check\" class=\"wp-image-3070\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/PSA-blood-test.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/PSA-blood-test.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/PSA-blood-test.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/PSA-blood-test.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/PSA-blood-test.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Most men meet PSA inside a health-check package rather than as a decision they made.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">There is no single number that means cancer<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A figure of 4 ng\/mL is widely used as a cut-off and is worth understanding rather than trusting. An earlier version of this article called it <em>the current standard definition of an elevated PSA<\/em>, which is tidier than reality.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Most men above 4 do not have cancer.<\/strong> The great majority of raised results have a benign explanation.<\/li>\n\n\n\n<li><strong>Cancer does occur below 4<\/strong>, so a result under the line is reassuring rather than conclusive.<\/li>\n\n\n\n<li><strong>What is normal rises with age<\/strong> and with the size of the prostate \u2014 a large gland makes more PSA simply by being large.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">PSA is made by prostate tissue, not by cancer specifically. Anything that enlarges, inflames or disturbs the prostate raises it.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What raises PSA, in rough order of how often<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Benign prostatic enlargement.<\/strong> By a wide margin the commonest reason, and the one the earlier version of this article left out of its list altogether.<\/li>\n\n\n\n<li><strong>Prostatitis or a urinary infection.<\/strong> These can push PSA up dramatically, and it can take weeks to settle afterwards \u2014 testing during or just after an infection is one of the commonest causes of a frightening result.<\/li>\n\n\n\n<li><strong>Recent instrumentation<\/strong> \u2014 a catheter, a cystoscopy, or a previous biopsy.<\/li>\n\n\n\n<li><strong>Urinary retention.<\/strong><\/li>\n\n\n\n<li><strong><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26328144\/\">Recent ejaculation<\/a><\/strong> \u2014 abstain for about 48 hours before the test.<\/li>\n\n\n\n<li><strong>Vigorous cycling<\/strong> in particular, in the day or two beforehand.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">And one thing that lowers it<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Finasteride and dutasteride roughly halve the PSA.<\/strong> If you take either \u2014 usually for an enlarged prostate or for hair loss \u2014 the number on your report understates your true level and has to be interpreted accordingly. This was mentioned only in passing at the foot of the earlier version, and it belongs here: a man on one of these drugs with a PSA that looks reassuring may not be reassuring at all. Tell whoever orders the test.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"534\" data-attachment-id=\"3067\" data-permalink=\"https:\/\/drsoaraweeurology.com\/fr\/2021\/05\/07\/what-should-you-do-if-high-psa\/cyclist-man-racing-bike-outdoor\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Bicycling.jpg?fit=1200%2C801&amp;ssl=1\" data-orig-size=\"1200,801\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;4&quot;,&quot;credit&quot;:&quot;PORNSAWAN&quot;,&quot;camera&quot;:&quot;NIKON D800&quot;,&quot;caption&quot;:&quot;Cyclist Man Racing Bike Outdoor&quot;,&quot;created_timestamp&quot;:&quot;1535810712&quot;,&quot;copyright&quot;:&quot;SANGMANEE&quot;,&quot;focal_length&quot;:&quot;24&quot;,&quot;iso&quot;:&quot;200&quot;,&quot;shutter_speed&quot;:&quot;0.001&quot;,&quot;title&quot;:&quot;Cyclist Man Racing Bike Outdoor&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Recent long distance bicycling can be another caused in PSA elevation.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Recent long distance bicycling can be another caused in PSA elevation.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Bicycling.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Bicycling.jpg?resize=800%2C534&#038;ssl=1\" alt=\"Man cycling, an activity that can transiently raise the PSA level\" class=\"wp-image-3067\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Bicycling.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Bicycling.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Bicycling.jpg?resize=1024%2C684&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Bicycling.jpg?resize=768%2C513&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/Bicycling.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Cycling in the day or two before the test can raise the reading \u2014 worth mentioning when you book it.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">The first step is usually to repeat it<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">PSA varies in the same man from week to week, and a proportion of raised results simply come back normal when checked again \u2014 particularly where there has been an infection, a catheter or a recent procedure, in which case the repeat is left several weeks.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Alongside the repeat comes a physical examination of the prostate, which gives information the blood test cannot. <strong>Nothing irreversible should follow from a single raised reading<\/strong>, and a man who is offered a biopsy on the strength of one number without a repeat is entitled to ask why.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What is used to decide whether a biopsy is needed<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The trend over time.<\/strong> A PSA climbing steadily across several readings means more than any single value. The earlier version of this article gave a rise of 0.75 ng\/mL per year as a threshold suggesting cancer; <strong>that figure has been removed<\/strong>, because rate of change is no longer accepted as a reason for biopsy on its own. It informs the picture rather than deciding it.<\/li>\n\n\n\n<li><strong>Free PSA ratio<\/strong>, which can help where the total PSA sits in the moderately raised range with a normal examination. The earlier version stated that a ratio below 10% indicates about a 50% cancer risk, without saying that this applies to that specific range \u2014 a qualifier that changes the meaning considerably.<\/li>\n\n\n\n<li><strong>MRI of the prostate<\/strong>, performed <em>before<\/em> any biopsy, and now the most useful of the three.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"3069\" data-permalink=\"https:\/\/drsoaraweeurology.com\/fr\/2021\/05\/07\/what-should-you-do-if-high-psa\/mri-machine-magnetic-resonance-imaging-machine-on-a-dark-blue-background-concept-medicine-technology-future-3d-rendering-3d-illustration-copy-space-2\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/MRI.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;MRI machine, magnetic resonance imaging machine on a dark blue background. Concept medicine, technology, future. 3D rendering, 3D illustration, copy space&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;MRI machine, magnetic resonance imaging machine on a dark blue background. Concept medicine, technology, future. 3D rendering, 3D illustration, copy space.&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"MRI Prostate is a promising modality for avoiding unnecessary prostate biopsy.\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;MRI Prostate is a promising modality for avoiding unnecessary prostate biopsy.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/MRI.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/MRI.jpg?resize=800%2C533&#038;ssl=1\" alt=\"MRI scanner used to image the prostate before deciding whether a biopsy is needed\" class=\"wp-image-3069\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/MRI.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/MRI.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/MRI.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/MRI.jpg?resize=768%2C512&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2021\/05\/MRI.jpg?resize=16%2C12&amp;ssl=1 16w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">MRI before biopsy is what allows some men to avoid one altogether.<\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">What the MRI figure actually means<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version credited MRI with <em>over 90% cancer detection rate<\/em>. That is a misreading of what the number describes, and it has been corrected.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The strength of prostate MRI is the reverse of detection: <strong>when it shows nothing suspicious, significant cancer is unlikely to be present<\/strong> \u2014 reliable enough that a reassuring scan, in the right clinical context, is a legitimate reason not to biopsy at all. That is genuinely valuable, and it is not the same as finding 90% of cancers. MRI misses some, its accuracy depends on the scanner and on who reads it, and a suspicious area still has to be sampled to know what it is.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If a biopsy is needed<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version described transrectal ultrasound-guided biopsy as <em>the definitive diagnostic test<\/em>. Practice has moved on, and this page now agrees with the rest of the site: the MRI images are fused with live ultrasound so the needle is aimed rather than scattered, and the needle is passed <strong>through the skin of the perineum rather than through the rectal wall<\/strong>, which is what makes serious infection uncommon. See <a href=\"https:\/\/drsoaraweeurology.com\/2024\/01\/13\/mri-transperineal-prostate-biopsy\/\">MRI-fusion transperineal prostate biopsy<\/a>, and <a href=\"https:\/\/drsoaraweeurology.com\/2021\/04\/30\/prostate-biopsy-instruction\/\">what to expect afterwards<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two things are worth knowing before you agree to one. <strong>A negative biopsy does not entirely close the question<\/strong>, since it samples part of the gland. And <strong>finding cancer does not automatically mean treating it<\/strong> \u2014 a proportion of prostate cancers grow slowly enough that monitoring is the right management, and the grade reported by the pathologist drives what follows. If treatment is needed, see the <a href=\"https:\/\/drsoaraweeurology.com\/services\/robotic-prostatectomy\/\">treatment pathway<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">And if you have not yet had a PSA test and are deciding whether to, that is its own question \u2014 <a href=\"https:\/\/drsoaraweeurology.com\/2020\/05\/21\/psa-screening-test\/\">should I have a PSA test<\/a>. The link on this page previously pointed to an address that no longer exists.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms that need attention rather than a repeat blood test<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Inability to pass urine with a painful full bladder \u2014 same-day treatment.<\/li>\n\n\n\n<li>Fever with pain low down or on passing urine.<\/li>\n\n\n\n<li>Visible blood in the urine or semen.<\/li>\n\n\n\n<li>New bone pain in the back, hips or ribs, or unexplained weight loss.<\/li>\n\n\n\n<li>New leg weakness, numbness, or difficulty controlling the bladder or bowel in a man known to have prostate cancer \u2014 this needs emergency assessment.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About a High PSA<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Does a high PSA mean I have prostate cancer?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. Most raised results have a benign explanation \u2014 benign enlargement of the prostate above all, then prostatitis or urinary infection, recent instrumentation, retention, recent ejaculation or vigorous cycling. PSA is made by prostate tissue generally, not by cancer specifically.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Is 4 ng\/mL the line between normal and abnormal?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">It is a widely used cut-off rather than a boundary between health and disease. Most men above it do not have cancer, some cancers occur below it, and what counts as normal rises with age and with prostate size.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What happens first after a raised result?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Usually the test is repeated, with an examination of the prostate \u2014 and left several weeks if there has been an infection, a catheter or a procedure. A proportion of raised readings return to normal on repeat. Nothing irreversible should follow from a single number.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How should I prepare for a PSA test?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Abstain from ejaculation for about 48 hours and avoid vigorous cycling for a couple of days beforehand. Tell your doctor about any recent urinary infection, catheter or urological procedure, and \u2014 importantly \u2014 if you take finasteride or dutasteride, which roughly halve the reading.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">My MRI was clear. Can I skip the biopsy?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Often, yes. A prostate MRI showing nothing suspicious makes significant cancer unlikely, and in the right clinical context following the PSA rather than proceeding to biopsy is a reasonable choice. It is not an absolute guarantee \u2014 MRI misses some cancers and its accuracy depends on the scanner and the radiologist \u2014 so it is a decision made together rather than an automatic discharge.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Soarawee Weerasopone sees patients at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a> and at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>. Bring <strong>every<\/strong> previous PSA result with its date rather than only the latest one \u2014 the trend is worth more than the number \u2014 along with a list of your medicines.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/05\/07\/what-should-you-do-if-high-psa\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2021\/05\/07\/what-should-you-do-if-high-psa\/\",\n      \"name\": \"A High PSA Result: What It Means, and What to Do Next\",\n      \"description\": \"Most raised PSA results have a benign cause, benign prostatic enlargement above all. The usual first step is to repeat the test, and MRI before biopsy allows some men to avoid one.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2021-05-07\",\n      \"dateModified\": \"2026-08-25\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2021\/05\/07\/what-should-you-do-if-high-psa\/#psa\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"disambiguatingDescription\": \"Several corrections were made. 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PSA is produced by prostate tissue generally rather than by cancer specifically.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Is 4 ng\/mL the line between a normal and abnormal PSA?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"It is a widely used cut-off rather than a boundary between health and disease. Most men above it do not have cancer, some cancers occur below it, and what counts as normal rises with age and prostate size.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"What happens first after a raised PSA result?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"The test is usually repeated together with an examination of the prostate, and left several weeks if there has been an infection, catheter or procedure. A proportion of raised readings return to normal on repeat, and nothing irreversible should follow from a single number.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"My prostate MRI was clear. Can I avoid a biopsy?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Often yes. An MRI showing nothing suspicious makes significant cancer unlikely, and following the PSA rather than proceeding to biopsy is reasonable in the right context. It is not an absolute guarantee, since MRI misses some cancers and accuracy depends on the scanner and radiologist.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>A raised PSA is not a diagnosis. The commonest reason for it is a benignly enlarged prostate, the first sensible step is usually to repeat the test, and a single number matters far less than what it does over time.<\/p>","protected":false},"author":185281453,"featured_media":10053,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"What a raised PSA actually means, the causes that must be excluded first, why the test should usually be repeated, and how MRI is used before deciding on biopsy.","jetpack_seo_html_title":"High PSA Result: What to Do Next | Dr. Soarawee Bangkok","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1364],"tags":[1400],"class_list":["post-3058","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-oncology","tag-high-psa"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-Nk","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/High-PSA-Result.webp?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/posts\/3058","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/comments?post=3058"}],"version-history":[{"count":24,"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/posts\/3058\/revisions"}],"predecessor-version":[{"id":11715,"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/posts\/3058\/revisions\/11715"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/media\/10053"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/media?parent=3058"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/categories?post=3058"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/fr\/wp-json\/wp\/v2\/tags?post=3058"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}