The PSA Question — To Test or Not to Test?

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In this episode

One blood test. One number. And one of the most debated decisions in men’s preventive health.

In this quick episode of the Stable Health Podcast, Sharon breaks down the PSA test—prostate-specific antigen—and what the result can and cannot tell you about prostate cancer.

A higher PSA does not automatically mean cancer. PSA levels can be affected by several factors, which is part of why prostate cancer screening isn't as simple as checking a number and calling it normal or abnormal.

Sharon explains why PSA screening can help detect prostate cancer earlier, while also introducing the other side of the conversation: false-positive results, additional testing, biopsies, and the possibility of finding cancers that may never have caused harm.

You'll also learn why there isn't one universal age when every man should begin screening. The decision should consider age, overall health, family history, individual risk, and personal preferences.

The goal isn't to tell every man to get a PSA—or to avoid one.

It's to help you understand the test well enough to have an informed conversation with your healthcare provider.

Because screening isn't just about finding disease. It's about understanding what happens after you look.

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All content is synthesized from peer-reviewed clinical evidence and reviewed by Stable Health Care Services. It does not constitute personalized medical advice.

One blood test. One number. And one of the most debated questions in preventive medicine: should you get it? The PSA test can catch prostate cancer early. It can also set off a chain of biopsies and treatments for cancers that would never have harmed you. Both statements are true, and that's exactly why this decision is yours to make. I'm Sharon, and you're listening to the Stable Health Podcast. This is episode 2 of our prostate health series, the PSA Question. PSA stands for prostate-specific antigen, a protein made by the prostate.

A small amount normally circulates in your blood, and the test measures how much. Here's the catch. PSA is specific to the prostate, not to cancer. Cancer can raise it, but so can BPH, prostatitis, a urinary infection, recent ejaculation, or even vigorous cycling. Many providers use about 4 nanograms per milliliter as a flag, but there's no magic cutoff. Cancers can hide below it, and many elevated results turn out to be benign. What matters is the trend over time and the full clinical picture. Here's the honest balance sheet.

The benefit? PSA screening can reduce deaths from prostate cancer by finding aggressive disease while it's still curable. The harms. False alarms that lead to anxiety and biopsies. Over-diagnosis, meaning finding slow-growing cancers that never would have caused problems. An over-treatment, because surgery or radiation can cause urinary leakage and erectile dysfunction. The good news is that medicine has gotten smarter. An MRI can now help decide whether a biopsy is needed, and many low-risk cancers can be safely watched with active surveillance instead of treated right away.

That's tipped the balance towards screening for the right men. Major guidelines agree on the core idea. This is a shared decision between you and your provider. For average risk men, that conversation typically happens between ages 55 and 69, and some guidelines start as early as 50. For higher risk men, start earlier, around 40 to 45. That includes black men who have higher rates and more aggressive disease, men with a father or brother diagnosed with prostate cancer, and those with known BRCA gene mutations.

After 70, screening is generally not recommended for most men, but your health and life expectancy matter. So the takeaway PSA isn't a yes or no test, it's a conversation. Know your risk, know the trade-offs, and decide with your provider. Next episode waking up three times a night to urinate. We'll talk BPH and what really helps. This episode is for education, not personal medical advice. Bring your questions to your own provider. I'm Sharon, this is Stable Health. Until next week, stay stable.