Prostate health and the PSA test: what to know
What a PSA test can and can't tell you, common prostate symptoms, and when your GP might refer you to a urologist.
What the prostate is
The prostate is a small gland below the bladder in men and people with a prostate. It often gets bigger with age. This is called benign prostatic hyperplasia (BPH) and it is not cancer, but it can affect how you pass urine.
Common urinary symptoms include:
- Needing to pass urine more often, especially at night
- A weak or stop-start stream
- Trouble getting started
- Feeling the bladder hasn't emptied
- Sudden urges that are hard to hold
These symptoms are usually due to BPH or other causes, not cancer. Early prostate cancer often causes no symptoms at all.
The PSA test
PSA (prostate specific antigen) is a blood test. A raised PSA can be a sign of prostate cancer, but it can also be raised by an enlarged prostate, infection, or recent activity like cycling.
PSA testing has benefits and downsides. It can find cancers early, but it can also lead to more tests and treatment for slow-growing cancers that might never have caused harm. That is why it is a personal choice. Talk with your GP about your age, family history and what matters to you. A strong family history of prostate or certain other cancers may mean starting the conversation earlier. Cancer Council has more information to help you decide.
When you might see a urologist
Your GP may refer you to Urology if:
- Your PSA is raised or rising over time
- Your prostate feels abnormal on examination
- Urinary symptoms are bothering you and not improving with first-line treatment
- You have blood in your urine or semen
A urologist may repeat the PSA, arrange an MRI and, if needed, a biopsy. Many raised PSA results turn out not to be cancer. If cancer is found, options range from active monitoring to treatment.
Referrals and costs
You need a GP referral for a Medicare rebate. Ask about fees before you book, see Bulk billing, rebates and gap fees explained. On Spec Book, your GP can see which urologists have the soonest appointments and send the referral with the booking.
When to get urgent help
Go to an emergency department if you cannot pass urine at all, or you have fever and pain with urinary symptoms.
Common questions
Should every man have a PSA test?
It is a personal decision. Talk with your GP about the possible benefits and harms for you.
Does a high PSA mean I have cancer?
Not necessarily. PSA can be raised for many reasons, and further tests are needed to know the cause.
Is a finger examination always needed?
Not always. Your GP or urologist will explain which checks are useful in your situation.
General information only, not medical advice. Everyone's situation is different, so check with your GP or the provider. In an emergency call 000.