The following questions and answers were developed in collaboration with Prostate Cancer Support

What is a PSA test?

A PSA (prostate-specific antigen) test is a simple blood test that measures the level of PSA, a protein made by the prostate. Higher levels can be a sign of prostate problems, including cancer, but can also be caused by non-cancerous conditions.

How do I get a PSA test?

If you’re over 50, you can ask your GP for a PSA test. They should explain the benefits and limitations so you can decide if it’s right for you. If you choose to go ahead, it’s usually done as a routine blood test at your GP surgery.

If I'm going for a PSA test, do I need to be examined with a finger up my bum?

The PSA test is a simple blood test. A physical examination (DRE) is sometimes used as part of a fuller assessment, but it is not part of the PSA test itself.

I haven’t got any symptoms so why should I bother?

Many men with early prostate cancer have no symptoms, which is why testing can help identify it at a stage when treatment may be more effective.

I’ve heard the PSA test can cause more harm than good.  Is that true?

In the past, some men were overtreated. Today, approaches like active surveillance mean many low-risk cancers are monitored rather than treated immediately. However, PSA testing can still lead to unnecessary investigations or anxiety in some cases.

I had a PSA test four years ago, is it necessary to do another one?

PSA levels are often more useful when looked at over time. The frequency of testing depends on individual risk factors (such as age, ethnicity, and family history), so it’s best to discuss your situation with a urologist or your GP.

I’ve heard that most men die with Prostate Cancer rather than of it, so why should I bother getting checked?

Many older men have slow-growing prostate cancer that may never cause harm. However, some prostate cancers are aggressive, which is why awareness and appropriate testing matter.

My mate told me the PSA test is a rubbish cancer test and not worth bothering with.  Is this why it’s not a screening test?

PSA is not a perfect test—it can be raised for reasons other than cancer. If PSA is elevated, further assessment may include repeat PSA testing, examination, and possibly imaging such as MRI, depending on the clinical situation.

I went to my GP and asked for a PSA test.  His receptionist said we don’t do them because they are not reliable.

Men over 50 have the right to discuss PSA testing with their GP. If, after understanding the pros and cons, they wish to proceed, the GP should usually arrange the test.

I saw my GP and asked for a PSA test and he said ‘we only do them when a man has symptoms’.  What should I do?

Even without symptoms, men over 50 can request a PSA test after discussing the benefits and risks with their GP.

My mother had breast cancer.  Does this make me more vulnerable?

If your mother carried a BRCA mutation, this can increase your risk. However, not all breast cancers are linked to BRCA genes. (BRCA is also linked to ovarian cancer)

I heard that if I have the BRCA gene it can increase my risk of prostate cancer.  What is this and how can I get it checked?

Genetic testing for BRCA mutations is usually offered through specialist services if there is a strong family history. It often involves a blood or saliva test, but access is guided by specific criteria.

My grandfather died of prostate cancer.  Does this make me more vulnerable?

Having a grandfather with prostate cancer increases your risk of developing the disease due to inherited genetic factors. While a father or brother with the disease poses a higher risk, a grandfather's history still makes you more vulnerable, especially if he was diagnosed under age 60.

I saw a PSA test kit in Home Bargains.  It was cheap, but how good are they?

Home PSA tests may be less reliable than laboratory tests and don’t include medical interpretation. Results should always be discussed with a GP, so they are generally not recommended as a substitute for proper testing.

I get up 3 times a night for a pee.  Could this mean I’ve got cancer?

It depends on many things, but it’s worth asking your doctor for their opinion.  Often there is no problem but it’s worth getting checked out. 

The doctor said I’ve an enlarged prostate.  Does this mean it can turn cancerous?

An enlarged prostate (benign prostatic hyperplasia) is not cancer and does not turn into cancer, but the two conditions can occur at the same time.

A pal of mine had a PSA test recently and his PSA was higher than normal.  He went through four weeks of anxiety and a number of others tests only to be told he didn’t have cancer.  I don’t fancy that, so I’m not going to have a PSA test, I’d rather not know.

It’s true that further tests can cause anxiety. However, NHS cancer pathways aim to complete investigations quickly (often within 28 days), and early detection can significantly improve outcomes. It’s a personal decision that should balance reassurance with potential stress.