The short answer
A raised PSA does not mean you have prostate cancer. PSA also rises with an enlarged prostate, a urine or prostate infection, recent ejaculation, vigorous exercise and age, and some men with cancer have a normal PSA. The difference is made by a urologist's examination, a repeat PSA, and where needed an MRI scan and a biopsy, so a single result is a reason to see a urologist, not a diagnosis.
See a urologist in LagosMedically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Two different conditions, the same symptoms
An enlarged prostate is a non-cancerous growth that is very common as men get older. It squeezes the urine tube, so it causes a weak stream, waiting to start, dribbling and getting up at night.
Early prostate cancer often causes no symptoms at all. When it does, the symptoms can look exactly like an enlarged prostate. That is why you cannot tell the two apart by how you pass urine, and why a doctor checks for cancer before treating an enlarged prostate. An enlarged prostate does not turn into cancer, but a man can have both.
What PSA is
PSA, prostate specific antigen, is a protein made by the prostate. A small amount leaks into the blood. Anything that disturbs or enlarges the prostate can push the level up, and cancer is only one of those things. The normal range also rises with age, so the same number can mean different things at 45 and at 75.
Things that raise PSA without cancer
Tell your doctor if any of these applied in the days before your test:
- An enlarged prostate
- A urine infection or prostate infection (prostatitis)
- Ejaculation in the previous 48 hours
- Vigorous exercise, especially cycling, in the previous 48 hours
- A recent prostate examination, catheter or procedure on the urine tube
- Some medicines lower PSA instead, such as finasteride, so tell the doctor about every tablet you take
What happens after a raised PSA
A good urologist does not jump straight to a biopsy. The usual order is:
- Treat any infection, then repeat the PSA after the right gap
- Examine the prostate with a gloved finger through the back passage, which takes less than a minute
- Consider your age, family history and the size of the prostate
- Arrange an MRI scan of the prostate if concern remains
- Offer a biopsy only if the MRI or examination suggests it is worthwhile
Why Nigerian men should not ignore it either
Black men have a higher risk of prostate cancer than other men, and it can appear younger. Men with a father or brother who had it are also at higher risk. Many prostate cancers grow slowly and never need treatment, but some grow faster, and in Nigeria too many are found late. A raised PSA deserves a calm, proper assessment by a urologist: neither panic nor a shrug.
If you are a man over 50, or over 45 with a family history, it is reasonable to ask a doctor about the pros and cons of PSA testing even with no symptoms.
See a doctor urgently if
Bone pain in the back or hips that is new and persistent, unexplained weight loss, blood in the urine or semen, or being unable to pass urine all need prompt medical attention, whatever your PSA says.
What it costs on Mezo
Two to three nights, catheter included.
Common questions
My PSA is high. Do I have cancer?
Not necessarily. Most men with a raised PSA turn out not to have prostate cancer. It means you need a urologist's assessment, often starting with a repeat test.
My PSA is normal. Does that mean no cancer?
It makes cancer less likely but does not rule it out. If the prostate feels abnormal on examination or symptoms continue, your doctor may still investigate.
Should I avoid sex before a PSA test?
Yes. Avoid ejaculation and vigorous exercise for 48 hours before the test, and do not have it while you have a urine infection.
If it is only an enlarged prostate, what is the treatment?
Usually lifestyle changes and tablets. Surgery such as TURP is kept for men whose symptoms are not controlled or whose blockage is causing harm.
The procedures
Related health guides
More patient guides
Sources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- PSA test. NHS. Patient information.
- Prostate cancer. NHS. Patient information.
- Enlarged prostate. NHS. Patient information.
Links last checked 22 October 2026.
Medical disclaimer: This guide is general information and does not replace advice from your own doctor. Where your centre's instructions differ from this guide, follow theirs.