The grading and staging of prostate cancer does not directly correlate with PSA. PSA is a sensitive indicator of prostate cancer, normally less than 4ng/ml in healthy men, and can be elevated, mostly less than 10ng/ml, when there is prostate inflammation, prostate enlargement, or recent prostate massage, prostate puncture, etc., but it cannot However, the possibility of prostate cancer cannot be ruled out. If prostate cancer has been diagnosed after imaging and prostate puncture biopsy and the PSA tested is between 4-10, it is considered low-risk prostate cancer according to the guidelines (less than 10 is low risk, between 10-20 is intermediate risk, and greater than 20 is high risk). However, whether prostate cancer is advanced is not judged based on PSA levels. Imaging or pathology confirms the presence of peripheral tissue invasion (T4), lymph node metastasis (N1), and distant metastasis (M1) for prostate cancer to be considered stage IV, or advanced, prostate cancer.
Is it possible that the PSA of advanced prostate cancer is between 4 and 10 because of the different systems of assessment? It is certainly possible, but the odds are too small. In most cases the later the graded stage of prostate cancer, the higher the PSA level. Thinking about it from this side, the probability that a PSA of 4-10 ng/ml and prostate cancer is advanced is not great, but not absolute.