PSA Density Calculator

PSA is produced by your prostate and alerts to potential issues:

Levels change with age – Normal levels at 40 differ from 60:

Not just about cancer – Infections or enlargement can also increase PSA:

• PSA is not a cancer test. As we discussed earlier, whilst high PSA can be because of cancer; it’s most often due to BPH a condition where the prostate gets bigger, but it is not cancerous. 
• BPH is common in men after 50 years of age, and can cause symptoms such as frequent urination. When the prostate is infected, known as prostatitis, this can also increase PSA levels. 
• Prostatitis caused by infection is treatable with antibiotics, and there are several treatments for managing BPH including oral medication and surgical options. 

What is the calculation?

Lets walk through the image above to better understand this.

Think of two glasses of water: 

Why is PSAD better than PSA alone?

• A high PSA alone might just mean a big prostate (BPH), but calculating PSAD shows the real risk of cancer: 

  • Likely harmless:
  • PSA of 6 ng/mL, in an 80cc prostate gives PSAD = 0.075 
  • Needs closer check: 
  • PSA of 6 ng/mL, in a 40cc prostate gives PSAD = 0.15
  Doctors use PSAD equal or greater than 0.15 ng/mL² as level where they take biopsies for further investigation.
  

Why is PSAD not perfect?

• Depending on the equipment used, the size estimates of the prostate can vary.
• For example Ultrasound/MRI can be off by 10–20% (e.g., 50cc could really be 45 to 55cc). 
• Additionally, PSA "false highs" can happened if there is an Infection present or catheter was used prior. All these can spike PSA temporarily, in such instances a period of at least 4 to 6 weeks must be allowed before testing.
  

1. Enter your Total PSA Level from your blood test report (units: ng/mL). Type it in the first box. Example: "6.5".
   
2. Choose Measurement Method 
1. Option A (Easiest): Use Direct Volume if your ultrasound/MRI report says "Prostate Volume" (in mL/cc), enter it. 
2. Option B: Use Dimensions if you have Length, Width, Height (in cm), enter all three.
3. Click "Calculate" to get your PSA Density (PSAD) instantly. The calculator will give a risk level (Low/Moderate/High) and recommended next steps. 
4. If you need to redo, click "Reset" to start fresh.

**All information is private, no data is saved or shared. You can print your results for easy reference or to share with your doctor or healthcare provider.**

This PSA density calculator calculates PSA density based on your PSA blood test result and prostate size.

The calculator works by dividing your PSA level (ng/mL) by your prostate volume (measured in cubic centimetres from ultrasound or MRI) . 

The calculator then gives you a risk level indication (low, moderate, or high) using the calculated PSA density. The calculator formula, thresholds and cutoff are derived from European Association of Urology (EAU) 2023 Guidelines.

Keep in mind that the calculator gives general guidance and should not be relied upon or used to replace medical advice. PSA density alone cannot definitively diagnose or rule out prostate cancer. 

Results should always be discussed with your doctor as they take into account your individual factors like age, family history, or physical examination findings. 

Your doctor will consider the results alongside other clinical information and imaging studies, giving you a more accurate interpretation and personalised advice.

Q1. What PSA density is a cancer risk?

• PSAD above 0.20 ng/mL/cc -  Higher prostate cancer risk. 
• PSAD between 0.10-0.15 ng/mL/cc - Intermediate cancer risk. 
• PSAD below 0.10 ng/mL/cc - Lower risk for significant disease.
  

Q2. What will happen if my PSA is raised?

• First, confirm raised PSA by repeating the test, importantly after addressing any temporary causes such as infections that could have caused it. 
• Additional tests like free-to-total PSA ratio or MRI can help assess prostate health. 
• Then a shared decision making process guides what further steps to be taken based on test results and individual patient factors.
  

Q3. Does a high PSA mean I have cancer?

• No, high PSA doesn't always mean cancer. Many non-cancerous conditions can cause high PSA. 
• About 70% of elevated PSA results are false positives, with only 25% of biopsies finding cancer. 
• Doctors consider multiple factors, including age and other tests, to get a better assessment of prostate health.
  

Q4. What is Normal PSA Density by Age?

• Below 50 years: Normal PSAD is usually below 0.10 ng/mL². 
• 50-59 years: PSAD up to 0.15 ng/mL² can be considered normal. 
• 60-69 years: Normal PSAD can reach 0.20 ng/mL².
• over 70 years: PSAD may approach 0.25 ng/mL².
  

Q5. What medications can increase PSA levels?

• Testosterone replacement therapy, especially intramuscular injections, can raise PSA. 
• Corticosteroids, like betamethasone, can also increase PSA levels in some cases. 
• On the other hand, medications such as 5α-reductase inhibitors (eg. Finasteride, Dutasteride), NSAIDs, statins, and thiazide diuretics can lower PSA levels.
  

Q6. What can cause a false high PSA reading?

• Recent ejaculation can lead PSA rising temporarily, especially in men over 50. 
• Intense exercise such as cycling, or physical activities involving the prostate can also increase PSA levels. 
• Prostate infections, swelling, or certain medical procedures like having a catheter can result in higher PSA readings.
  

Q7. How to Lower PSA Levels?

• Evidence suggests incorporate dietary changes like consuming cooked tomato products rich in lycopene, a powerful antioxidant, can help.
• Adopting a healthy lifestyle with regular exercise, stress management, and increased fibre intake.

• Consult healthcare providers before making any significant changes to your diet or start supplementing. They can help you with creating a personalised plan that works for you whether it be natural approach or using tried and tested medicines.