Who should go for PSA test


Prostate-specific antigen PSA Test

What is Prostate-specific antigen PSA Test?

Prostate-specific antigen PSA is a protein produced by cells of the prostate gland. This test determines the level of PSA in the blood. As PSA is produced by the body sometimes it is also called a biological marker. It is also known as a tumor marker. Elevated PSA levels may indicate prostate cancer, a noncancerous condition such as prostatitis, or an enlarged prostate.

It is normal for men to have a low level of Prostate-specific antigen (PSA) in their blood; but, prostate cancer or conditions can increase the PSA level. As the age progress, both benign prostate conditions and prostate cancer become more common. The Prostate-specific antigen (PSA) level alone is not the only information to distinguish between benign prostate and cancer. However, the doctor will take the outcome of the PSA test into account while deciding whether to check further for signs of prostate cancer.

Symptoms of Prostate Problems

symptoms prostate-specific antigen PSA

Many men begin to have problems with their prostate as they get older. Most problems are caused by simple enlargement of the prostate, but a few are caused by cancer. To get checked for Prostate Cancer consult with your GP.

Usually, the first sign of trouble is with passing urine. A man may notice one or more of the following symptoms:

  • trouble getting the flow of urine started, especially if in a hurry
  • trouble stopping the flow of urine (“dribbling”)
  • the stream of urine is weak, or it stops and starts
  • needing urgently to pass urine at any time
  • feeling a need to pass urine more often during the day, even though not much comes out
  • getting up at night to pass urine more than once
  • feeling a need to pass more urine, even though none comes out
  • pain and/or burning when passing urine; this may be a sign of infection

For whom might a Prostate-specific antigen PSA test be recommended?

Doctors’ recommendations for Prostate-specific antigen PSA test varies. Some encourage yearly PSA test for men over age 50, and it is advised to men who are at a higher risk for prostate cancer to start screening at age 40 or 45. Others caution against routine PSA test. Although specific recommendations PSA test vary, men should be informed about the potential risks and benefits of PSA test before a test.

Several risk factors increase a person’s chances of developing prostate cancer. These factors are taken into consideration when a doctor recommends screening. Age is one of the most common risk factors, with nearly 63% of prostate cancer occurs in men age 65 and older. Some of the risk factors for prostate cancer are as mentioned below:

  • family history
  • race
  • possibly diet

PSA test

Person who has father or brother with prostate cancer has a greater chance of developing prostate cancer. There is also some evidence that diet rich in fat, especially animal fat, red meat may increase the risk of prostate cancer.

Normal Prostate-specific antigen PSA test result

There is no normal or abnormal range specified for PSA level in the blood. PSA levels of less than and equal to 4.0 ng/mL are considered normal by most of the Doctors. Therefore, if a person has PSA level of more than 4.0 ng/mL, doctors usually recommend a prostate biopsy to determine whether prostate cancer was present.

Most men have PSA levels under four (ng/mL) and this has traditionally been used as the cutoff for concern about the risk of prostate cancer. Men with prostate cancer often have PSA levels higher than four, although cancer is a possibility at any PSA level. According to published reports, men who have a prostate gland that feels normal on examination and a PSA of less than four have a 15% chance of having prostate cancer. Those with a PSA between four and 10 have a 25% chance of having prostate cancer and if the PSA is higher than 10, the risk increases and can be as high as 67%.

Benign Enlargement of the Prostate

In men with prostate problems, nine out of ten will have a prostate which has grown too big. This puts pressure on the urethra and may squeeze it enough to block the outflow of urine.

This condition of enlarged prostate is called “Benign Prostatic Hyperplasia” or BPH. Benign means it is not cancer, and hyperplasia means “too much tissue”.

BPH occurs with aging. It affects more than half of all men older than 50.

Medicines or surgery are used to treat it but only when symptoms become troublesome. Remember, BPH is not prostate cancer even though most of the symptoms are the same when passing urine.

Infection of the Prostate

Infection of the prostate is called Prostatitis. It can cause pain, fever, swelling of the prostate, and blood and pus in the urine.

It may have symptoms similar to BPH. Prostatitis is usually treated with antibiotics. Infection of the bladder usually occurs at the same time as infection of the prostate. If blood appears in the urine (Haematuria), contact your doctor for an appointment.

Detecting prostate cancer early may not reduce the chance of getting prostate cancer.

Prostate-specific antigen PSA test can help detect small tumors that usually do not show symptoms. Finding a small tumor, however, may not necessarily reduce a person’s chance of getting prostate cancer. Some tumors found through PSA test grow so slowly that they are hardly life-threatening.

Prostate-specific antigen PSA test for men who have been treated for prostate cancer?

The PSA test is used to monitor patients who have a history of prostate cancer to check if their cancer has recurred. If a person’s PSA level begins to increase after prostate cancer treatment, it may be the first symptom of a recurrence.

A single increased PSA test results in a man who has a history of prostate cancer does not always a sign of a recurrence. A man who has been taking treatment for prostate cancer should discuss the increase in PSA level with his doctor. The doctor may ask for repeat PSA test or may recommend other tests to check for evidence of a recurrence.

What does an increase in PSA level mean for a man who has been treated for prostate cancer?

If the PSA level increases after prostate cancer treatment, the doctor may consider a number of factors before recommending any further treatment. Additional treatment based on a single PSA test is usually not recommended. The doctor may observe the trend of rising PSA level over a period of time rather than a single elevated PSA level.

Limitations of the test

The limitations of PSA testing include:

  • PSA-raising factors. Besides cancer, other conditions that can raise PSA levels include an enlarged prostate (benign prostatic hyperplasia, or BPH) and an inflamed or infected prostate (prostatitis). Also, PSA levels normally increase with age.
  • PSA-lowering factors. Certain drugs used to treat BPH or urinary conditions, and large doses of certain chemotherapy medications may lower PSA levels. Obesity can also lower PSA levels.
  • Misleading results. The test doesn’t always provide an accurate result. An elevated PSA level doesn’t necessarily mean you have cancer. And many men diagnosed with prostate cancer have a normal PSA level.
  • Overdiagnosis. Studies have estimated that between 23 and 42 percent of men with prostate cancer detected by PSA tests have tumors that wouldn’t result in symptoms during their lifetimes. These symptom-free tumors are considered overdiagnoses — identification of cancer not likely to cause poor health or to present a risk to the man’s life.

It is important to understand that the PSA test is not perfect. Most men with elevated PSA levels have noncancerous prostate enlargement, which is a normal part of aging. Conversely, low levels of PSA in the bloodstream do not rule out the possibility of prostate cancer. However, most cases of early prostate cancer are found by a PSA blood test.


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