Both healthy and cancerous cells of the prostate gland produce the protein known as PSA, which is particular to the prostate. The PSA test quantifies the PSA concentration in the blood. As part of this procedure, a blood sample is submitted to a lab for analysis. PSA levels in the blood are often expressed as nanograms (ng/mL) of PSA.
FDA approved the PSA test initially in 1986 to track the progression of prostate cancer in men who had previously been diagnosed with the disease. Prostate cancer patients frequently have elevated blood levels of PSA.
The PSA test was given FDA initially approved the PSA test in 1994 to be used in conjunction with a digital rectal examination (DRE) to help diagnose prostate cancer in males 50 years of age and older. Many medical professionals and organizations had, up until roughly 2008, advised yearly PSA testing for prostate cancer starting at age 50.
For patients who report prostate symptoms, health care professionals frequently employ PSA testing (together with a DRE) to help them identify the source of the issue.
Several benign (non-cancerous) diseases, including benign prostatic hyperplasia (BPH), prostatitis (prostate inflammation), can also cause increased PSA level in addition to prostate cancer (enlargement of the prostate). Although there is no proof that either disease increases the risk of developing prostate cancer, a person with one or both of these illnesses may nonetheless do so.
What is a normal PSA test result?
There is no certain PSA blood level regarded as normal or abnormal. PSA concentrations of 4.0 ng/mL or less were regarded as normal, in the past. However, many people with higher PSA levels between 4 and 10 ng/mL do not have prostate cancer, and some people with PSA levels below 4.0 ng/mL do.
Additionally, a person’s PSA level may change due to several causes. For instance, age, the size of the prostate gland, and inflammation or infection are all likely to elevate the PSA level. A recent prostate biopsy, as well as ejaculation or strenuous exercise (like cycling) two days before testing, will raise the PSA level.
On the other hand, some medications, such as finasteride and dutasteride, which are used to treat BPH, may also lead to spiked PSA levels. However, in general, a man’s risk of having prostate cancer increases with his PSA level.
Why doctor’s order a PSA test?
Prostate cancer, one of the most common cancers in men, causes elevated levels of prostate-specific antigen (PSA). Although many other conditions may also cause increased PSA levels, and it is not specific to prostate cancer, it is a useful tool to screen for early signs of prostate cancer. PSA test combined with a digital rectal exam (DRE), is very helpful and many a times diagnostic in prostate cancer.
PSA is also elevated in benign prostatic hyperplasia, which is a premalignant condition and makes a person at high risk of prostate cancer. This test is also done to judge the effectiveness of a treatment, and also to check for recurring cancer.
What are the benefits of the PSA test?
The main benefits of the PSA test are,
- To detect prostate cancer at an early stage, which helps in better treatment and cure.
- To screen high risk individuals for prostate cancer
- This is sometimes tricky, as the typical course of prostate cancer is a slow progression, which sometimes causes prostate cancer with no symptoms and no increase in PSA levels.
Why do I need a PSA test?
You and your healthcare provider may evaluate your risk for prostate cancer and may determine if you need a PSA test or not. The major risk factors for prostate cancer and the indications for the PSA test are as follows,
- Higher Age: The risk of prostate cancer increases after the age of 50.
- Family History: You are at higher risk of having prostate cancer if members of your family have had prostate cancer.
- Race: African Americans are more at risk of prostate cancer. They also have a higher risk of developing prostate cancer at an early age, and these are the ones where PSA tests should be done routinely.
Other indications of the PSA test may include symptoms of painful or frequent urination (peeing), blood in urine or semen, and pelvic or back pain. If you have prostate cancer already, you may also need a PSA test to monitor your progress and if the treatment is working or not.
How PSA Test is done?
It is just a blood test. A health care professional will draw blood from one of your veins via a small syringe, which may sting a bit. And that is all that takes to have a PSA test. You will have to avoid sex or masturbation for 24 hours before your test, which is necessary as releasing semen can falsely elevate your PSA. Besides, there are no certain risks of having a PSA test, but certain medications can alter their results, so consider seeing your healthcare provider before the test.
References:
- PSA test. (2021, June 22). Mayo Clinic – Mayo Clinic. https://www.mayoclinic.org/tests-procedures/psa-test/about/pac-20384731
- The prostate-specific antigen (PSA) blood test. (2002, February 20). WebMD. https://www.webmd.com/prostate-cancer/guide/psa
- Prostate cancer screening tests. (n.d.). American Cancer Society | Information and Resources about for Cancer: Breast, Colon, Lung, Prostate, Skin. https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/tests.html
- Prostate-specific antigen testing. (2021, October 4). Diseases & Conditions – Medscape Reference. https://emedicine.medscape.com/article/457394-overview
- Elevated prostate-specific antigen level: Ranges & diagnosis. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15282-elevated-psa-prostate-specific-antigen-level
