What Is a Normal PSA for a Man Without Prostate Cancer? | Ask a Prostate Expert, Mark Scholz, MD

PCRI's Alex, asks medical oncologist, Mark Scholz, MD, about the benefits and limitations of PSA testing and what men need to know to get the most out of this powerful albeit flawed method of screening for prostate cancer.

0:05 What are the origins of PSA?

2:07 Why is PSA testing controversial?

3:15 What should a normal PSA be for a man without prostate cancer?

4:00 What if your PSA is less than 1?

5:02 What is the significance of "PSA density," or the ratio of the PSA to the size of the prostate gland.

6:08 What steps should a patient take if he has a high PSA and a large prostate?

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The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better individualized care. Feel free to explore our website or call our free helpline at 1 [phone] with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.

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[andrewrivera]

My PSA had been rising during my 40’s finally topping out at 6.35 when I was 52 years old, I had 2 urologists screaming at me there was no way lower your PSA and that I needed a biopsy! I started KETO/OMAD and started doing longer fasts periodically, fast forward 2 years my PSA had dropped to 3.0! Now at 58 years young my PSA is 2.9, I asked my doctor how this could be, she ran out of the room! We all need to educate ourselves and take charge of our health!

[yiotisdemetriou]

If you have enlarged prostate DO not ejaculate before psa test for at least 5 days, six days even better. Do not measure psa if you have constipation. My psa was day 1 after ejaculation 7.4, 3 days after 6.7, 4 days after 6.4, 5 days after 6.1, 6 days after 5.7. Prostate size 52cc age 58. Take lycopene supplement 25mg every day, it will also drop psa. Hope that helps. 🙏

[eddyjimenez-scorpio]

Man o man, this is all my uro needed to tell me. In 5 mins of this clip, i learned more about my psa and prostate than i did in 4 yrs with my doctors.

[presleyrules]

My VA doctor had been checking my prostate for years. He once said "I know it's uncomfortable but a time may come when I find something wrong". That time came in Feb. 2013 when he felt 2 small bumps. In Mar. 2013, I was sent to Urology where the pathologist said "Something is wrong". A biopsy was done in late-April and the results came back in early-May; positive for stage T2C adenocarcinoma (which means it was in both lobes of the prostate). In Jun. 2013, an oncologist told me it had reached stage T3A (it was outside the prostate). He told me that, at the rate it was moving, I would have maybe 5-6 years to live without treatment. I opted for radiation treatment; had that done in Sept.-Nov. 2013. Since that time, my PSA has been at 0.1 or lower; I'm checked every year by the VA. For the previous 6 years prior to my doctor finding those bumps, my PSA had been between 1.01 and 1.67. The day he found those bumps in 2013, my PSA was 2.07; which is still very low. I was 59 at the time I went thru this. Today, I'm 68 and thank God every day I'm still here!

[CALVINLNIKONT]

I was 75 and I hadn't had a prostate test ever. I fell out of bed and my back started to ache, so I went to the hospital for an X-ray. The X-ray showed a need for a CAT scan and while I was at the hospital, in spite of the fact that I had been feeling great, they took some blood tests. The blood test showed that I was in perfect health except for the fact that my PSA was 61...not 6.1!
I was scheduled for a needle biopsy and cancer was inside both sides of my prostate. They took a whole-body CAT scan and found that the cancer was still just in my prostate. To be extra sure, they gave me an MRI of my entire pelvic region and the cancer was still only in my prostate. I decided to go for radiation therapy. First, they put me in some stirrups as if I were having a baby and injected about 20 rods between my legs, and gave me internal radiation with a new treatment that doesn't leave any radiation inside of your body. Next, they gave me the first of 4 shots in my rear end the effect of which lasts for 6 months that kills the testosterone that the cancer uses as food. Then I had 10 minutes of external radiation every day for 25 days. After my last of four shots to kill the testosterone, we waited 6 months for the last shot to wear off and then waited another 4 months to check my PSA and testosterone. The PSA is ZERO!!! and my testosterone is raising. I will have another blood test in 3 months and another blood test 3 months after that to make sure that the PSA stays at zero and the testosterone continues to rise.
The Lord has been very good to me!

[TC-eoeb]

I am 63 years old and had a PSA blood draw performed and it was 5.5. Neither my primary provider or my Urologist told me that ejaculating 24 hours prior to a PSA blood test would cause my PSA to be falsely elevated. I discovered this fact while doing my own research. I did ejaculate the day before my blood draw. I waited 3 months and had my PSA rechecked and made sure I did not ejaculate for a week before my blood draw. My recheck was 5.1. I believe providers need to do better job educating patients on this.

[bodymind]

Excellent sir...when a common non medical man can't get informed even after visiting drs.. urologist.. your evidence based information is great great help to people all over the world...thx to whole team for their constant effort to upinform the people...

[tonybullcity]

I really like this channel. Im 51 now but back in January 25, 2022 my Psa was 2.93. August 10, 2022 was 3.99. February 19, 2023 was 3.19. Today July 19, 2024 doctor said it drop significantly to 2.48. It was a great feeling to see that on my chart. God is good. And change my diet up alot.

[gavinfoster]

Dr Scholz is really reassuring and informative. Also the young lady who does the interviewing does an excellent job as well

[YourThermalWorld]

That young lady is a wonderful interviewer! I’ve just been referred to a Urologist as my PSA doubled from last year so I’m doing my initial research. These interviews and presentaions are very helpful in alleviating my anxiety.

[mr.ronaldlawrence]

Awesome and relevant video. I am over 50 years old and my PSA peaked from 4 to 6 then lowered to 4.5. I have no symptoms and everything else, blood pressure, blood sugar, weight, etc are measured as normal. I am consulting with an urology surgeon, oncologist, research scientist and local cancer patients to explore my options. The oncologist described my condition as an intermediate cancer risk compared to individuals that are low risk and high risk. Thankfully, the body scan and bone scan did not detect any evidence of cancer. However, the biopsy detected a small malignant tissue in one of my prostates. My urologist has recommended aggressive surveillance to continually monitor the situation. As I stated earlier, I am exploring my options.

[yugnauj]

To whoever can benefit from my own personal case.

My PSA has always been high but I did not know it as a young man. The very first time I heard about PSA was from a routine work test in 1995 (I was 50 years old). He really scared me to death when he said my PSA was so high above the 10 or 12 that most men had when they have cancer. So I was the willing sheep and went through my first biopsy. Big mistake. After the biopsy I began to leak pee — little, but it never went away and this leaking condition was not there before the first biopsy. The biopsy came negative and I forgot all about it until one day at a bar with friends I realized that I could not pee at all. That was around 2009, fourteen years after the first biopsy.

Confused because it never happened before, I went home and spent the whole night trying to pee; nothing; big pain as the bladder got bigger full of liquid and began pressing all my organs; I asked god to please kill me cause I did not know what to do and the pain was maddening. I called a friend; explained that I could not drive and my friend took me to the hospital. At the hospital (UCLA at Torrance, California) they put a catheter in my ureter (first time ever) and all my pain went away immediately. From that day on I learned to put catheters my self and I always keep a supply in my car, at work, and in my home; it is inconvenient to insert a catheter but not a big deal and the relief is immediate and I prefer to do it myself because I take my time whereas in the hospital they simply push it through no matter what. Another thing that I learned was that drinking was a big factor for my prostate health so I stopped drinking. In my car and at work (when I worked, retired now) I use to keep gloves and hand sanitizer to disinfect the gloves and the catheter.

After that first catheter experience, in 2009 my PSA was 16. I went through my second biopsy at Harbor UCLA Medical Center in California. Negative. I promised myself I will never get another biopsy just because my PSA is elevated, the risk of infections is very high. And I have not and will not go through another biopsy.

So fast forward to 9/16/2019 my PSA according to Quest Diagnostic was 19.2. Dr. Neyssan Tebyani in Orange County, one of the best urologists in California was worried about me. I told him that I am already used to high PSA and I will not be going through any surgery or shaving of my prostate or another biopsy - rectal exam okay once a year. You can call Dr. Tebyani and ask if he has a patient with almost 20 PSA to confirm.

I take Flomax every day and I urinate the same as I have urinated in the last decade. I am 74 now. My case may be unique or not. I do not recommend anyone to do what I did. I am just saying that Urology needs to conducts a meta-study to certify the percentage of men who have elevated PSA and live a normal life cancer free. I guess the resulting info from such meta-study would not be good for the field because it is good money to do the biopsies and good practice for graduating doctors in teaching hospitals who are in need of cases to practice.

l researched the average PSA level for cancer patients and it is around 10.

In 2021 I will ask my urologist to give me the medicine that reduces the size of the prostate. I am aware of the reduction of libido with that medicine and for that reason alone I have been refusing it but at my age I am ready for it in order to pee better and avoid frequent trips to the bathroom.

Again, my case is only for those readers who have high PSA levels for decades and live cancer free. I hope this help them.

[stevegonzales]

My PSA was between 4 and 12 for a whole yr...in Sept 2020, a cancer cell was found. It was determined it was an aggressive cell, so in Oct 2020, my prostate was removed. As of Aug 2021, ALL is back to normal (PSA), with all functions working 100% again...!! 👊

[Kismainspires]

These conversations are so reassuring for me as the wife of a prostate cancer survivor

[kangaroobooks]

I too am a victim of the discernible prostate fickle fairy of fate. I was living my life feeling good when I took the PSA, and when the results came back I was told, I was not. In my youth, I was a sailor, but then it was my doctor that gave me what I never had before, a rectal exam, a biopsy, and PSA with a very high, bell-ringing score. If I were to live my life over again, I would limit my life to cigars and whiskey, fast horses and women and gin.❤

[WritewheelUK]

Hi. Thanks for the video. It came a bit late for me as my PSA came in at 15.1, then 6 months later had increased significantly, the concern being the speed. Had MRIs which showed an anomaly. One a year later showed it more clearly and I went for a biopsy. That was uncomfortable, but no more than that. They found cancer on one side, and I have just finished radiotherapy. My post-treatment PSA is 0.02.

Anyone putting off going for test or treatment should be aware it is no great test. The only side effect from the radiotherapy that I found difficult to cope with was lethargy. It was all-pervading. Never felt so tired over a period before. Even two weeks after treatment, I was suffering. I lost hair on my thighs. This appears, now 6 weeks later, to be permanent. No bother. However, there's a parting, about half-and-inch wide in my pubic hair. As I came out of the shower once, my wife looked at my bits and started laughing. No man wants that of course. She said it looked like a face of a man with big eyes, a large nose (honest. She said that.) and a lop-sided grin. Not sure how that last bit works.

All in all, no problem. One of the most easily treatable potentially fatal cancers. I met a chap while waiting for my turn for radiotherapy who left it too late and the cancer spread into his bones and organs. He had weeks to live. The only reason he was having radiotherapy was to ease the pain in his side. His wife came with him, not wanting to waste a moment of their time left together.


The last thing every one of us, including you, will do on this earth is hurt those who love you, and hurt the ones who love you the most the most. Put it off as long as possible. Go for a PSA test.

[georgeconway]

My story. D.O.B. 1947, Retired age 65 2012 . 2017 PSA 2.1 had creeped up over previous years an increase of 1.1 in 24 months. Primary care physician scheduled tests every 24 months but in hindsight realized he had some concern because he palpated my prostate because that was a first for him. 24 months later just before age 72 I had my P.S.A.. which was 9.0. Had a second test 30 days later it was 8.4. Scheduled an appointment with a urologist and the P.A checked my prostate and said I should get a biopsy. That Internet said I still had only a 50% chance of cancer at that PSA. Had the biopsy, not a big deal, just a little uncomfortable but in hindsight found it should have been done on 2017. The doctor called to tell me is was positive. My first question was “What was the Gleason Score?” It was 9. The only good news was it was not 10. At an office visit I discussed it with the Doctor and he recorded it as Stage 1B. Went through additional work ups CATScans and such, met with a Radiologist and discussed various options. Approximately 8 weeks after the biopsy I met with the Doctor and advised I would like surgery which was scheduled about a month later. During that wait the Doctor said he would like me to meet with another surgeon about a problem discovered with my gallbladder. It was decided I would get two surgeries the same day, one to remove my prostate and the second to remove my gallbladder. After surgery I would wait 6 months to get 7 weeks, 34 Radiation treatments. Everything turned out well and now I take Ultra Sensitive PSA tests every 3 months. My PSA is now less than .01 which is considered undetectable which means I’m cancer free. After Surgery my pathology report said I had Stage 3b Cancer. If I had my biopsy in 2017 or my doctor had ordered another PSA 12 months later rather than 24 months it would have been much better in my opinion.

[katrinamclaughlin]

Great practitioner. Great video. Thank you for your knowledge in this field. It has helped so many men with this cancer.

[Richiea]

I'm in my 70s and I made a mistake a few years ago of thinking my rising PSA was just a sign of old age. The doctor finally convinced me to get a biopsy and it turned out that I did have has since been treated. So guys don't ignore the warning signs.

[dbvnyc]

I do wish all our Doctors were like Dr. Scholz. Perfect bedside manner. Other physicians can take a leaf out of his book!