PSA is the most important indicator for the early detection of prostate cancer. The normal value is 4ng/ml, but some conditions such as prostate enlargement, acute prostatitis, and prostate cancer can cause an increase in PSA levels. Therefore, an elevated PSA does not always mean prostate cancer, but may also be a result of other prostate diseases. Currently, we recommend that patients have a prostate puncture biopsy if the PSA is >4ng/ml to rule out prostate cancer. However, even in patients with a negative prostate puncture, prostate cancer cannot be ruled out completely because the prostate is relatively large and we usually only perform 12 punctures, and there may be prostate cancer in areas that are not penetrated.