IADT3since2000

There is also a higher chance that there is no cancer, but that something else is going on.

All that said, the bottom line is that getting more information would be wise. Other blood tests are often helpful before going ahead with a biopsy, though age is a factor. If you are young, say younger than about 50, that's a pretty high PSA. If you are in your 70s or older, that PSA is on the low side of normal. These differences are due to the fact that the prostate enlarges in its normal course as we age, for most of us, and it produces more PSA as it gets larger. However, cancer cells produce a lot more PSA than normal cells.

The two key other tests are the "free PSA" test, where you hope to see that more than 25% of the total is "free," and you hope that the percent will not be 10% or lower, which indicates a fairly high risk of prostate cancer but not certainty, and the PCA3Plus test, which is probably the most informative test at this point, though most doctors are not yet familiar with it. You can search the archives of this board, including recent posts, and learn more about it.

That normal ultrasound IS worth something. It suggests there are no very large prostate cancer tumors in the prostate. Hopefully there are not any tumors there at all.

Infection, inflammation, benign enlargement, and some other causes are more likely causes of elevated PSA than cancer, but the PSA is like a sentry who has noticed something suspicious- it should not be ignored.

Good luck!

Jim