Why Roswell Park Should Consult on Elevated PSA Levels

An elevated PSA score could indicate progress toward prostate cancer, or it might be considered a “normal” range for a patient – a complex and nuanced situation that will be the focus of a new program at Roswell Park Comprehensive Cancer Center.

“Patients are having PSA tests, whether as part of screening once they turn 50… or if they have urinary symptoms, or because the patients ask for a PSA test,” says Helen Cui, a urologist at Roswell Park. “How we manage the results can be very nuanced and we are seeing patients who maybe didn’t need to have a PSA or maybe had a low PSA and didn’t need to be investigated or patients who had a high PSA for their age which they didn’t think would need to be investigated but actually does.”

The new program for monitoring patients with elevated PSA levels to better provide individualized care, in addition to those with general urologic symptoms, Dr. Cui says. “Some people will need a work-up straight away to investigate for prostate cancer whereas some will need their PSA rechecking and the intervals at which we recheck it and the velocity at which we expect the PSA to rise – these are all individualized to the patient depending on the size of the prostate, the likelihood they have other conditions which may raise the PSA.”

The experts at Roswell Park are able to provide a robust risk stratification for the patient to discuss not only their current risk level but the possible treatment options available if cancer does develop.

Even if a patient has what might historically be considered an average or low PSA, based on their family history and other factors, it might be worth seeing a urologist at Roswell Park.

“The reason we want to see these patients early is that we get the right investigations done, because they’re able to offer them all of the different options from active surveillance to focal treatment to surgery to radiation. We need to have the most accurate information available” in order to provide the best treatment options, Dr. Cui says.