What PSA means
Prostate-specific antigen (PSA) is a protein made by the prostate. A higher-than-expected PSA does not mean you have cancer. PSA can rise with an enlarged prostate, inflammation or infection, recent ejaculation, cycling or a recent procedure. It is a signal that deserves a careful look, not a diagnosis.
The evaluation
Dr. Neal Patel usually starts by repeating the PSA, reviewing prior values to see the trend, examining the prostate and checking for infection. Depending on the result, additional tools may include a free PSA or other blood or urine biomarkers and a prostate MRI. MRI can identify suspicious areas and helps many men avoid a biopsy they do not need.
If a biopsy is recommended
When a biopsy is needed, MRI-targeted biopsy samples the suspicious areas directly, along with standard samples. Many practices now favor a transperineal approach, through the skin between the scrotum and anus, which has a lower infection risk. Results are discussed in person with a clear explanation of the grade (Gleason score / Grade Group) and what it means.
If cancer is found
Many prostate cancers are slow-growing and can be safely watched with active surveillance. For cancers that need treatment, options include robotic radical prostatectomy and radiation, sometimes combined with hormone therapy. Dr. Neal Patel completed fellowship training in advanced robotics at the USC Institute of Urology and has clinical research experience in prostate cancer, including PSMA PET imaging.
Newer options for localized cancer
For selected men with localized, intermediate-risk cancer, focal therapy that treats only the tumor area is an emerging option. Learn about Vanquish steam ablation focal therapy.
Who should be screened
Screening decisions are individual. Guidelines generally suggest a shared decision about PSA screening for men 55 to 69, and earlier conversations for men at higher risk, including Black men and those with a strong family history. Call 678-344-8900 to schedule an evaluation.
Preparing for your visit with Dr. Neal Patel
Bring a list of your current medications and supplements, any prior urine, blood or PSA results, and the reports (or discs) from recent imaging. If you can, arrive with a comfortably full bladder, because a urine sample and a bladder scan are often part of the first visit. Write down your main questions so nothing is missed. A family member is welcome to join you. If you prefer Spanish or Korean, let the office know when you book so language support is ready.
Your chart is reviewed before you arrive, and insurance requirements for likely imaging or procedures are checked up front so approvals can move sooner. Before you leave, your orders, prescriptions and follow-up plan are reviewed with you, and you receive education materials tailored to your condition.
At the end of the visit you will receive a written summary in your preferred language that explains what was found, what was ordered and what happens next. Your primary care physician or referring doctor receives a clear update letter with findings, plan and next steps, so everyone caring for you stays informed. Appointments are available at the Johns Creek, Cumming, Decatur and Braselton offices; call 678-344-8900.
Reviewed by Dr. Neal Patel, MD, board-certified urologist. This page is general information and not a substitute for medical advice.