Private PSA test for prostate conditions

Your GP or a urology specialist may recommend a PSA test if you have symptoms that could be linked to your prostate. These include:

• needing to pass urine more often, especially at night

• difficulty starting to pass urine, or a weak flow

• a sudden or urgent need to pass urine

• blood in your urine

• problems getting or keeping an erection (erectile dysfunction)

You may also have PSA tests to monitor an existing prostate condition or to check how well treatment is working.

If you don’t have symptoms

Prostate cancer doesn’t always cause symptoms, particularly in its early stages. However, the UK doesn’t have a national screening programme for all men, and PSA testing isn’t routinely recommended if you feel well.

If you’re concerned, you can still talk to a GP or specialist about whether a test is right for you. This is especially important if you have a higher risk of prostate cancer.

You may be at higher risk if you:

•  are a Black man

•  have a close family history of prostate cancer

•  have certain inherited gene changes, such as BRCA2

A PSA test can help find prostate cancer earlier, including aggressive cancers, when there may be more treatment options. However, the result isn’t always clear-cut, so it’s important to understand the limits of the test before you decide to have one.

The test itself is very safe. You may have slight bruising or tenderness where the blood sample was taken. The main drawbacks are:

• a raised result can be a false alarm. Your PSA may be high even though you don’t have cancer. This can cause worry and lead to further tests you didn’t need

• a normal result can miss cancer. Some people with prostate cancer have a PSA level in the expected range

• it can find cancers that would never harm you. Some slow-growing prostate cancers never cause symptoms or affect your health

• treatment may not always help. Treating a slow-growing cancer can cause side effects without bringing a clear benefit

How we reduce these risks

Your consultant won’t rely on your PSA level alone. They’ll consider it alongside your age, symptoms, medical history,  and any other test results.

If your PSA is raised, we may repeat the test or use further checks, such as free PSA, Stockholm3 or an MRI scan, before recommending a biopsy. If you’re diagnosed with a slow-growing cancer, you may not need treatment straight away.

We offer 3 blood tests:

• Total PSA: Measures the amount of PSA in your blood. Usually the first test

• Free PSA: Measures the PSA in your blood that isn’t attached to other proteins. Used as a follow-up test if your total PSA result is borderline

• Stockholm3: Combines blood markers, including genetic markers, with details such as your age and family history to give a more detailed picture of your risk

Your consultant will advise which ones are right for you.

Some activities and health problems can raise your PSA level for a short time. Following this advice helps make your result more reliable.

In the 48 hours before your test

Please avoid:

•  ejaculating, including through sex or masturbation

•  anal sex

•  cycling, including on an exercise bike

•  vigorous exercise or anything that leaves you out of breath

You can eat and drink as normal. You don’t need to fast.

What to tell your consultant

Your consultant may ask about your medical history, any urinary symptoms and any previous prostate tests or treatment. Please let them know if you:

•  have a urinary tract infection (UTI), or recent symptoms such as burning when you pass urine, a fever or pain in your pelvis

•  have recently had a prostate biopsy, a catheter or another procedure on your urinary system

• take finasteride or dutasteride, which are used to treat an enlarged prostate and hair loss

If you’ve had a UTI, you’ll usually need to wait 4 to 6 weeks after it has cleared before having a PSA test. A recent procedure can also affect your result, so your consultant may suggest delaying your test.

Finasteride and dutasteride can lower your PSA level, and your consultant will take this into account. Don’t stop taking any prescribed medicine unless your consultant tells you to.

We’ll take a small sample of blood from a vein in your arm and send it to a laboratory, where your PSA level will be measured. It usually takes just a few minutes, and you won’t need an anaesthetic.

There’s no recovery time, so you can drive, go to work and exercise as usual straight afterwards. Any small bruise or tenderness usually settles within a few days without treatment. 

Once your results are available, your consultant will review them alongside your medical history and any symptoms you’ve reported.

If your PSA level is in the expected range

If you don’t have any concerning symptoms, you may not need further tests.

A normal result doesn’t completely rule out prostate cancer. Seek medical advice if you develop new or persistent urinary symptoms, even if your last result was normal. 

If your PSA level is raised

If your PSA level is raised or your symptoms suggest a prostate condition, we’ll arrange an appointment with one of our consultants. They’ll discuss the next steps with you, which may include:

• a repeat PSA test, to check whether the level is still raised

•  an MRI scan, to look for any suspicious areas in your prostate

•  a prostate biopsy, but only if it’s needed to check for cancer or help plan your treatment

When to get urgent medical help

If you can’t pass urine, seek urgent medical attention. If you see blood in your urine, get it checked promptly, even if a previous PSA result was reassuring.

There’s no single normal PSA level for everyone. In England and Wales, doctors use these age-based levels to help decide whether someone with possible prostate symptoms needs further assessment. 

•  under 40: Your doctor will use their clinical judgement

• 40 to 49: Above 2.5

• 50 to 59: Above 3.5

• 60 to 69: Above 4.5

• 70 to 79: Above 6.5

•  80 and over: Your doctor will use their clinical judgement

Some reports show PSA in µg/L, which is the same as ng/mL.

If you’re diagnosed with a prostate condition, your consultant will explain your options at a follow-up appointment. Not everyone needs treatment straight away, and some slow-growing prostate cancers can be closely monitored instead. This is called active surveillance.

We offer focal therapy, which treats the affected part of the prostate rather than the whole gland. Our focal therapy options include: 

•    HIFU, which uses focused ultrasound

•    NanoKnife, which uses electrical pulses

•    cryotherapy, which uses extreme cold

Focal therapy isn’t suitable for everyone. Your consultant will explain what’s known about how well it works, and what’s still uncertain. 

We don’t currently offer surgery to remove the prostate (radical prostatectomy), radiotherapy, or chemotherapy on site. If one of these is right for you, your consultant can refer you to an experienced colleague elsewhere.

Our men’s health specialists work alongside colleagues across other specialties. If you need care from another specialist, we can usually refer you within Welbeck as quickly as possible.

Your appointments, tests, follow-up and any treatment we offer all take place at Welbeck, which keeps your care in one place.

You’ll need a referral from your GP or a urology specialist, following a consultation with them. We can’t accept self-referrals for this test.

To see one of our urology specialists, please contact us to make an appointment. We aim to offer same-day appointments whenever possible.

Please contact our Men’s Health centre for prices.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once your insurer has given authorisation. We also care for self-paying patients.