Taking a PSA test soon? Here is all you need to know.
PSA Testing: What Is It And What To Expect
What Is a PSA Test?
PSA test stands for Prostate Specific Antigen test. It is an important blood test in helping diagnose prostate cancer in men who are showing no symptoms.
Prostate specific antigens (PSA) is a type of protein the prostate gland produces. The prostate gland is a reproductive gland in males that manufactures the semen, which is a fluid that contains the sperm cells.
The prostate gland is a walnut-sized gland located under the bladder, and is wrapped around the urethra. The urethra is the tube connected to the bladder and along which urine passes to exit the body.
While PSA is produced by healthy cells in the prostate gland, even malignant cells produce it. As the PSA test measures PSA levels in a man’s blood, and elevated levels are often a sign of prostate cancer.
The PSA test was approved in 1986 by the FDA. It was to monitor prostate cancer progression in men who have already been diagnosed.
In 1994, the FDA further approved the PSA test along with DRE (digital rectal exam) to test men for prostate cancer before taking a biopsy.
Who Should Take the Prostate Specific Antigen Test?
Consult with your primary care physician and/or urologist if you should be taking a PSA test. The American Cancer Society, however, recommends men at certain ages and with specific medical and genetic history to take annual PSA tests:
- Men at the age of 50, who don’t have major health problems.
- Age 45 and above for men that have a high risk for prostate cancer. Those with a first-degree relative diagnosed with prostate cancer before the age of 65 are particularly at risk.
- Men at 40 years of age that many first-degree relatives diagnosed with prostate cancer before the age of 65.
What Do the Test Results Mean?
Currently, there is no specific amount of PSA level in the blood considered normal or abnormal. PSA levels vary over time.
In the past, PSA levels of 4.0ng/mL and lower has been the standard of normal PSA levels, and anything higher would call for a prostate biopsy. But recent studies have shown that men with prostate cancer can have low PSA levels, while cancer-free subjects had high levels of PSA.
Generally, higher PSA levels have come to mean a higher likelihood of prostate cancer. A continuous rise of PSA levels may also be indicative of prostate cancer.
A man without symptoms of prostate cancer who undergoes a PSA test and is found to have high PSA levels may be recommended another PSA test by their doctor. This is to confirm if the original findings are true and to rule out any PSA fluctuations.
The doctor may also order a urine test to rule out a urinary tract infection. Other tests the doctor might recommend are x-rays, cystoscopy, or transrectal ultrasound.
Do High PSA Levels Mean Cancer?
Elevated PSA levels don’t always mean cancer. There are many other reasons for higher PSA levels, such as:
- Urinary tract infection
- Prostate biopsy
- Prostate surgery
- Enlarged prostate gland (Benign Prostatic Hyperplasia/BPH)
- Chemotherapy/chemotherapeutic medication
- Physical activities targeting prostate gland, such as cycling
What Are PSA Test Variations?
Doctors may use a variety of other ways to interpret any PSA test results before ordering a biopsy. Here are some of the variations on PSA testing:
- PSA Velocity – PSA velocity is how PSA levels change over a period of time. This tracks rapid rises in PSA levels, which may indicate the presence of cancer.
- PSA Density – Prostate cancer produces more PSA than any other benign prostate condition. PSA density tests adjust the PSA values according to prostate value. Take note that this test usually requires a transrectal ultrasound or an MRI, and does not immediately require a biopsy.
- Percentage of Free PSA – There are 2 forms of PSA that circulate in the blood: those attached to blood proteins and those that are unattached or free PSA. High PSA levels with a low percentage of free PSA may be a likely sign of prostate cancer.
How Do You Treat Elevated PSA Levels?
High PSA levels aren’t bad for anyone. They are simply used as a biological marker, or as a sign for an underlying condition like prostate cancer.
PSA levels may be continually tested even after a diagnosis and prostate biopsy. This is to test whether treatments are proving effective, or to check if a treated cancer is recurring in men with prostate cancer.
Talk to your doctor about getting a PSA test done, and to find out whether your age and genetic history qualifies you to take the test earlier.
If you have any questions or would like to schedule an appointment for a PSA Test or evaluation in Peoria, IL, call Midwest Urological Group at (309) 692-9898.