Total prostate-specific antigen hovering between 4 and 6 may be caused by a tumor. Normal values for total prostate-specific antigen are 0 to 4 ng/ml. if the patient hovers between 4 and 10 ng/ml, it may be a tumor. If it is greater than 10ng/ml, an enlarged prostate is suspected. Total prostate-specific antigen (PSA) can generally be used as a screening indicator for prostate cancer, but a diagnosis of malignancy cannot be made solely on the basis of an elevated PSA; a prostate biopsy and pathology are required to confirm the diagnosis. This is because an elevated prostate-specific antigen index may be due to prostatitis or prostate hyperplasia, which results in an elevated total prostate-specific antigen index. Significantly elevated total prostate-specific antigen requires consideration of the possibility of prostate cancer, but further tests are needed for diagnosis. Prostate cancer cannot be diagnosed by this index alone.