Does a high PSA always mean cancer?

No. PSA (prostate-specific antigen) is a protein produced by prostate tissue, and a raised level can also result from benign prostate enlargement, prostatitis, some recent procedures or temporary irritation of the prostate. What counts as "normal" varies with age, prostate volume and laboratory, so a single number should never be judged alone; the result must be interpreted by a urology specialist together with age, examination, previous values and, if needed, tests such as prostate MRI.