Do not look at the absolute value. The 4 ng/ml cutoff has done much damage by delaying life saving treatment for those under 4.. There are large numbers of prostate cancer patients with significant disease with values such as 2. On the other hand, there are also patients with a 4ng/mL higher who were treated unnecessarily, because there are several reasons for PSA values to fluctuate unrelated to cancer.

So, what to do, The proper way to use PSA is to track it over time and look for a progressive rise over time. This patient needs more frequent testing, particularly with a family history. It should start now.

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