Prostate Specific Antigen (PSA), Total
Total PSA measures the amount of prostate-specific antigen in blood. Elevated levels may indicate prostate cancer, benign prostate enlargement, or prostate inflammation. Discuss screening guidelines with your doctor.
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- Includes Doctor Consultation
- Physician-reviewed
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2 to 3 days
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What the Prostate Specific Antigen (PSA), Total test tells you
Prostate-specific antigen is an enzyme made by the glandular tissue of the prostate. Its job is local (it thins semen after ejaculation), but a small fraction always leaks into the circulation, and that is what a total PSA test measures. Because essentially only the prostate produces it in quantity, the blood level acts as a general indicator of how much prostate tissue there is and how disturbed that tissue is.
That last point is the crux of the test. PSA is specific to the prostate but it is not specific to prostate cancer, and a raised result is not a diagnosis of cancer. By far the commonest reason for a raised PSA is benign prostatic hyperplasia, the age-related enlargement that affects a very large proportion of men as they get older. Prostatitis, a urinary tract infection, recent ejaculation, a long cycle ride, a catheter or a recent prostate examination all lift it as well, sometimes considerably and usually for a limited period. A raised result therefore opens an investigation rather than closing one, and it is normally confirmed on a repeat sample before anything is decided. The reverse is also true: an unremarkable PSA does not exclude prostate cancer, because a minority of tumours release little of the enzyme.
Where PSA is unambiguously useful is after a prostate cancer diagnosis, where the trend over time is the standard way of following treatment and detecting recurrence. Its use in men with no symptoms is a genuine trade-off rather than a settled question: testing can find some cancers early enough to matter, and it can also lead to biopsies and treatment for cancers that would never have caused harm in a man's lifetime, with side effects that are real. Neither consideration cancels the other out. Because the balance depends on your age, your health, your family history and how you would want to act on an abnormal result, the decision to test is one to make in conversation with your doctor before the sample is taken rather than after.
Standard prostate cancer screening test for men over 50, or over 40 with a family history. Also used to monitor treatment response in diagnosed prostate cancer.
- Informed early detection
PSA can reveal prostate cancer before symptoms appear, which is why it is offered to men who have weighed the benefits and drawbacks with their doctor.
- Explaining urinary symptoms
In men with a weak stream or waking at night to pass urine, PSA helps sort benign enlargement from something that needs further assessment.
- Surveillance after treatment
Following treatment for prostate cancer, a rise in PSA is usually the earliest reliable sign that disease has returned.
- Tracking active surveillance
For low-risk disease being watched rather than treated, serial PSA measurements form part of deciding whether and when to intervene.
Reasons your doctor may request the Prostate Specific Antigen (PSA), Total test
Your doctor may order this test for any of the reasons below. Some are routine checks, others follow specific symptoms or an earlier result.
An informed decision to test
- You and your doctor have discussed the pros and cons of prostate testing and decided to proceed.
Urinary symptoms & examination findings
- You have urinary symptoms such as hesitancy, a poor stream or frequent night-time waking.
- Your prostate felt abnormal on examination.
- You have unexplained bone pain that your doctor is investigating.
Family risk & follow-up after treatment
- You have a close relative with prostate cancer or another reason to be at higher-than-average risk.
- You have been treated for prostate cancer and attend for scheduled follow-up.
A result in the Normal band, 0 to 4 ng/mL, is the commonly used reference and is reassuring without being conclusive, since some prostate cancers release little of the enzyme. A Borderline result, 4.1 to 10 ng/mL, sits in the grey zone where further evaluation is often advised: a repeat, a free-to-total comparison, or a specialist opinion. A High result, 10.1 to 100 ng/mL, is a reason to look further, not a diagnosis in itself. PSA is specific to the prostate but not to cancer. Age-related benign enlargement is by far the commonest explanation for a raised value, and prostatitis, a urinary tract infection, recent ejaculation, vigorous cycling, a rectal examination, catheterisation or a biopsy can each lift it for days. Finasteride, dutasteride and testosterone therapy change how the figure must be read. Your doctor interprets it alongside your symptoms, examination and history.
Medically reviewed by Dr Nirupama Sabhapathy
Ranges are a guide: your physician interprets your result alongside your symptoms and history.
What a higher result can point to
- Benign prostatic hyperplasia, the age-related enlargement that is by far the commonest explanation.
- Prostatitis or a urinary tract infection.
- Prostate cancer.
- Recent ejaculation, vigorous cycling or horse riding.
- Digital rectal examination, prostate massage, catheterisation, cystoscopy or biopsy shortly before the sample.
- Acute urinary retention or another cause of pressure on the gland.
These are possibilities, not diagnoses. A single value outside the reference range is interpreted alongside your symptoms, history and other tests: your doctor decides what it means for you.
What this test cannot tell you
- PSA is specific to the prostate but not to cancer, so most raised results have a benign explanation and none is a diagnosis on its own.
- An unremarkable PSA does not exclude prostate cancer, since some tumours release little of the enzyme.
- Finasteride, dutasteride and testosterone therapy alter PSA measurements and change how a result must be read.
- Whether testing men without symptoms does more good than harm is genuinely contested, and the decision belongs to you and your doctor together.
Risks of the blood draw
- Mild bruising or brief soreness where the needle went in.
- Occasional lightheadedness, which settles after a few minutes of rest.
- Bleeding or infection at the site, which is rare with sterile single-use equipment.
- 1Only the prostate makes PSA in quantity, so the test is organ-specific but not disease-specific.
- 2A raised result is a reason to look further, not a diagnosis of cancer.
- 3Benign enlargement, infection and anything that physically disturbs the prostate can raise the value for days.
- 4A result within the laboratory's usual range does not guarantee the absence of prostate cancer.
- 5Testing when you have no symptoms carries both potential benefit and potential harm, so discuss it with your doctor first.
Prostate Specific Antigen (PSA), Total also comes in these focused packages, which pair it with the tests usually read alongside it.
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Free PSA measures the unbound form of prostate-specific antigen. The ratio of free to total PSA helps distinguish prostate cancer from benign…
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Frequently Asked Questions
Everything you need to know about the Prostate Specific Antigen (PSA), Total test. Can't find what you're looking for?
Talk to our team→Our laboratory reports 0 to 4 ng/mL as the commonly used normal range for total PSA. A result of 4.1 to 10 ng/mL is borderline, a grey zone where a repeat, a free-to-total comparison or a specialist opinion is often advised. A result of 10.1 to 100 ng/mL is high and is a reason to look further, not a diagnosis in itself.
PSA is commonly used for prostate screening in men over 50, or over 40 with a family history of prostate cancer. Whether testing men without symptoms does more good than harm is genuinely contested, because it can lead to further tests for harmless findings, so the decision belongs to you and your doctor together. Men with urinary symptoms are assessed regardless of age.
Total PSA measures all the PSA in the blood, both the part bound to proteins and the part circulating freely. Free PSA measures only the unbound part. When total PSA falls in the borderline grey zone, comparing free with total can help your doctor judge whether benign enlargement or something needing closer evaluation is more likely.
Yes. Finasteride and dutasteride, used for prostate enlargement and hair loss, lower PSA, while testosterone therapy can change it too, so the figure must be read differently. Saw palmetto is also worth mentioning. Tell the laboratory and your doctor what you take, and do not change any medicine before the test without your doctor's advice.
Yes. Recent ejaculation, long cycle rides or horse riding, a digital rectal examination, prostate massage, catheterisation or cystoscopy can each lift PSA for days. That is why the blood should be taken before, not after, any such examination or procedure, and why several weeks are allowed after a prostate biopsy before testing.
No. Benign enlargement, inflammation and infection account for most raised results. Your doctor will usually confirm the value on a repeat sample, examine the prostate, and only then consider imaging or a biopsy.
It is reassuring but not conclusive. A minority of prostate cancers release little PSA, so persistent symptoms or an abnormal examination are investigated whatever the blood test shows.
Some variation is expected and comes from the assay itself, from minor irritation of the gland and from infection. That is why a single raised value is repeated before anything is decided, and why the trend over years matters more than a jump between two visits.
Because after removal the value should become undetectable, which makes it an unusually sensitive alarm. Any measurable and rising PSA afterwards suggests prostate tissue is still active somewhere, and your oncologist will investigate that.
No fasting is needed. Avoid ejaculation for about two days before the sample, and skip long cycle rides or horse riding in the same period, as both can raise PSA.
The PSA test is AED 80, including a physician-reviewed report, with results usually within 2 to 3 days. Home collection anywhere in Dubai is free when your order reaches AED 300 or includes a package; below that, a AED 100 home collection fee applies (AED 50 for a lab walk-in).