text: is the psa test a good gage of cancer?   if a rectal exam was normal, your doctor may repeat the psa test to see if it remains high. results from this test do not confirm a diagnosis of prostate cancer. other conditions can raise a psa level including an enlarged prostate, an infected or inflamed prostate, or prostate biopsy or surgery. further testing may include a transrectal ultrasound. a tissue biopsy is needed to make the diagnosis of prostate cancer.