The prostate is a walnut-sized gland located below the bladder in a man’s reproductive system. This gland plays a role in semen production and helps propel sperm in the process of reproduction. The prostate produces a substance known as prostate-specific antigen, which is a protein. Low levels of PSA [...]]]> What is the PSA Test?

The prostate is a walnut-sized gland located below the bladder in a man’s reproductive system. This gland plays a role in semen production and helps propel sperm in the process of reproduction. The prostate produces a substance known as prostate-specific antigen, which is a protein. Low levels of PSA in the blood are normal, but a high level of PSA can indicate the presence of prostate inflammation, prostate cancer or prostate enlargement. Medical professionals use the PSA test, along with other information, to determine if a man has a benign prostate problem or prostate cancer.

Ordering Information

When a man has signs or symptoms of prostate cancer, prostate infection or prostate inflammation, his doctor might order the PSA test. The signs and symptoms of a prostate gland problem include the following:

• Pelvic pain
• Back pain
• Frequent urination
• Painful urination
• Difficulty urination

Testing Procedure

This simple test involves drawing a sample of blood from a vein in the arm. This causes relatively little discomfort, but those who are anxious about needles should discuss their concerns with a medical professional. A laboratory technician analyzes this blood sample to determine how much prostate-specific antigen is present. Men are advised to avoid ejaculation for at least 24 hours before the test, as it can alter the amount of PSA in the blood.

Results

Generally speaking, the normal value of PSA in the blood is less than 4.0 nanograms per milliliter (4.0 ng/ml). However, some laboratories use different reference ranges to determine what is normal and what is abnormal. Anyone who has a PSA test should discuss the results with a physician. The American Cancer Society says that a PSA level above 10.0 ng/ml indicates a more than 67 percent chance that a man has prostate cancer. PSA levels in between these two values may indicate benign conditions, but there is also a 25 percent chance that a man with a PSA level ranging from 4.0 to 10.0 ng/ml has prostate cancer.

There are variations on the PSA test that give more information about a man’s risk for prostate cancer. PSA velocity is a measure of PSA levels over time. If a man’s PSA increases significantly over two or three years, it is more likely that he has prostate cancer than a benign condition. If the PSA velocity increases quickly, the man might have a particularly aggressive form of prostate cancer. PSA doubling time provides similar information, except it is a measure of how quickly PSA doubles. Physicians also consider PSA density when determining a man’s cancer risk. Men with larger prostate glands tend to produce more prostate-specific antigen. PSA density compares the concentration of PSA in the blood with the volume of the prostate gland.

There are some factors that can alter PSA test results even if a prostate problem is not present. Any rigorous physical activity that affects the prostate can cause PSA levels to increase temporarily. If a man has had a prostate biopsy or resection of the prostate, PSA levels will be significantly increased. The PSA test should not be done until six weeks after the procedure to ensure accuracy. Some drugs used to treat cancer, such as methotrexate and cyclophosphamide, may also affect PSA levels. Because so many factors can alter PSA levels, many doctors will recheck any abnormal results before recommending a course of action. This can prevent the unnecessary surgery and complications associated with prostate cancer misdiagnosis.

Disease Detection

It is important to note that the PSA test does not detect all forms of prostate cancer. Some cancer cells do not produce excess prostate-specific antigen, so a PSA test will not always reveal an abnormality.

The prostate-specific antigen test (PSA test) helps determine the amount of a special protein in the blood. The protein is produced by a small gland in the male reproductive system known as the prostate. Low amounts of PSA in the blood do not usually indicate a problem, but [...]]]> Who Should Take the PSA Test?

The prostate-specific antigen test (PSA test) helps determine the amount of a special protein in the blood. The protein is produced by a small gland in the male reproductive system known as the prostate. Low amounts of PSA in the blood do not usually indicate a problem, but elevated amounts of this protein can help diagnose prostate infections, prostate enlargement and prostate cancer.

Testing Recommendations

Men who have an increased risk of prostate cancer should get the PSA test and an annual digital rectal exam. The rectal exam can help a physician identify abnormal changes in the prostate gland. Men over the age of 50 have an increased risk for this type of cancer, with most prostate cancer found in men who are at least 65 years of age. Physicians start offering PSA testing when a man turns 40 and make the testing available until a man’s life expectancy is 10 years or fewer. Once life expectancy is at this stage, the likelihood of developing a type of prostate cancer that would cause serious complications is greatly reduced. Since African-American men have an increased risk of prostate cancer, they should undergo this blood test. Consumption of a high-fat diet, exposure to industrial solvents and a family history of prostate cancer are also reasons to get this test.

The screening recommendations for this type of cancer vary from one organization to the next. The American Urological Association recommends a baseline PSA test at the age of 40. The AUA also encourages men to discuss the risks and benefits of this test with their physicians. The American Cancer Society recommends that PSA testing start at 50 years of age unless a man has an increased risk of prostate cancer. The age recommendation is 45 for a man with a high risk of prostate cancer and age 40 for a man with a very high risk of prostate cancer. Someone who had several relatives with prostate cancer is in the high-risk group. Several major organizations do not recommend PSA screening. According to the Centers for Disease Control and Prevention, there is no sufficient evidence to indicate a need for PSA testing. The U.S. Preventive Services Task Force actually recommends against the screening in healthy men. USPSTF says that PSA testing offers no real benefit for men who are not at an increased risk for prostate cancer.

Test Limitations

Although the PSA test can help detect cancer in some men, the test has some limitations. It is not necessarily a life-saving test because it can help detect small tumors that pose very little risk for death. False positives are also a concern for men who undergo this test. This is when a man has an increased PSA level and does not have cancer. The presence of an increased PSA level can lead to unnecessary tests and surgical procedures. False negatives are another concern related to PSA testing. A false negative is when a man has prostate cancer, but his PSA level is normal. Without additional tests, the cancer remains undetected and may have the opportunity to spread to other parts of the body. There is a lot of controversy surrounding the use of this test as a screening tool for prostate cancer because it is not known if the benefits of the test outweigh the risks of additional diagnostic tests and treatments. If a physician orders a prostate biopsy based on the results of the PSA test, the biopsy could cause complications such as infection and bleeding.

Making a Decision

The decision to get a PSA test is a very personal one and should only be made after a detailed discussion with a physician. A man with no risk factors for prostate cancer may find that the potential risks of PSA screening outweigh the possible benefits of the test. Those who have one or more risk factors for this type of cancer may decide to get the test to ease their concerns about developing prostate tumors. If a PSA test reveals an elevated amount of PSA in the blood, a doctor will recommend additional testing to confirm or rule out the presence of prostate cancer.

The PSA test determines the amount of prostate-specific antigen, a protein, in the blood. All men have low levels of this protein in their bloodstreams, but increased levels of PSA can indicate the presence of issues affecting the prostate gland. In some cases, an elevated PSA level indicates [...]]]> Why is the PSA Test Useful?

The PSA test determines the amount of prostate-specific antigen, a protein, in the blood. All men have low levels of this protein in their bloodstreams, but increased levels of PSA can indicate the presence of issues affecting the prostate gland. In some cases, an elevated PSA level indicates the presence of prostate cancer. The PSA test, along with a digital rectal exam and other diagnostic tests, can help physicians determine the best plan of action for treating men who have the signs and symptoms of prostate problems.

Symptoms of Prostate Problems

The prostate gland wraps around the urethra, the tube that carries urine from the bladder to the outside of the body. This walnut-sized gland produces a fluid that mixes with the semen and carries sperm through the reproductive system. When the prostate gland is inflamed, infected or affected by disease, the problem can cause increased urinary frequency, trouble urinating, pain while urinating, fever, difficulty starting the urine stream, painful ejaculation, fatigue and chills. The PSA test can be a useful tool for determining if these symptoms indicate the presence of an infection or a more serious problem.

Prostatitis

Prostatitis is a condition that causes inflammation and swelling of the prostate gland. In some cases, it is caused by a bacterial infection, but other cases have no known cause. Symptoms of this condition include flu symptoms, difficulty urinating, painful urination and pelvic pain. People with nervous system disorders, immune system disorders and injuries to the prostate have an increased risk of prostatitis. The PSA test is useful for people with prostatitis because it can help physicians diagnose the condition early and treat it as soon as possible. Without proper treatment, prostatitis can lead to epidydimitis, abnormalities of the semen and the spread of bacteria to the blood. Once a PSA test helps diagnose prostatitis, antibiotics, pain relievers and alpha-blockers may lessen the symptoms and eliminate any bacteria in the prostate gland.

Benign Prostatic Hypertrophy

Benign prostatic hypertrophy (BPH) refers to enlargement of the prostate gland. This is not a cancerous condition, but it can cause bothersome symptoms. More than 90 percent of men over the age of 90 have some form of prostate enlargement, but younger men can also develop BPH. Signs and symptoms of this condition include incontinence, increased nighttime urination, inability to urinate, painful urination, weak urine stream, bloody urine and delayed started of the urine stream. Fewer than 50 percent of men with BPH have these symptoms, however. The PSA test is useful for diagnosing BPH because it can help rule out prostate cancer and other conditions affecting the prostate. There are several treatment options for this condition. For mild cases of BPH, avoiding caffeine and alcohol can help ease some of the symptoms. Pelvic strengthening exercises can help men with BPH better control their urinary function. If these self-care measures do not help, antibiotics, alpha-1 blockers and finasteride can treat the underlying cause of the BPH.

Prostate Cancer

Prostate cancer starts in the prostate and, without treatment, can spread into nearby organs. This type of cancer is the most common cause of death from cancer in men who are 75 and older. Several groups of men are at an increased for this type of cancer. They include men over the age of 60, men with a family history of prostate cancer, African-American men, men who are exposed to industrial chemicals, farmers, men who eat a diet high in saturated fat, and men who abuse alcohol. Because the symptoms of prostate cancer are similar to those of BPH and prostatitis, a delay in diagnosis is possible. In men who have urine leakage, bloody urine and other urinary symptoms, the PSA test can determine if a man might have cancer. In men with PSA levels above 10.0 ng/ml, there is a significant chance that cancer is present. The only way to confirm a diagnosis of prostate cancer is to perform a biopsy on the prostate. When a biopsy is performed, the pathologist reports the results using a Gleason grade and a Gleason score to indicate the severity of the cancer.

Low-grade prostate cancers have Gleason scores of 2 to 4. Intermediate cases have Gleason scores of 5 to 7. Scores of 8 to 10 indicate high-grade cancer. In addition to the PSA test and prostate biopsy, bone scans and CT scans can help determine if the cancer has spread to other pelvic organs. Men with prostate cancer may have repeat PSA tests to determine if the treatments used are effective. Some of the treatments used for this type of cancer include surgery, hormone therapy and radiation therapy. These treatments can cause long-term complications and may affect sexual function or cause incontinence.

The prostate is a walnut-sized gland located below the bladder in a man’s reproductive system. This gland plays a role in semen production and helps propel sperm in the process of reproduction. The prostate produces a substance known as prostate-specific antigen, which is a protein. Low levels of PSA [...]]]> What is the PSA Test?

The prostate is a walnut-sized gland located below the bladder in a man’s reproductive system. This gland plays a role in semen production and helps propel sperm in the process of reproduction. The prostate produces a substance known as prostate-specific antigen, which is a protein. Low levels of PSA in the blood are normal, but a high level of PSA can indicate the presence of prostate inflammation, prostate cancer or prostate enlargement. Medical professionals use the PSA test, along with other information, to determine if a man has a benign prostate problem or prostate cancer.

Ordering Information

When a man has signs or symptoms of prostate cancer, prostate infection or prostate inflammation, his doctor might order the PSA test. The signs and symptoms of a prostate gland problem include the following:

• Pelvic pain
• Back pain
• Frequent urination
• Painful urination
• Difficulty urination

Testing Procedure

This simple test involves drawing a sample of blood from a vein in the arm. This causes relatively little discomfort, but those who are anxious about needles should discuss their concerns with a medical professional. A laboratory technician analyzes this blood sample to determine how much prostate-specific antigen is present. Men are advised to avoid ejaculation for at least 24 hours before the test, as it can alter the amount of PSA in the blood.

Results

Generally speaking, the normal value of PSA in the blood is less than 4.0 nanograms per milliliter (4.0 ng/ml). However, some laboratories use different reference ranges to determine what is normal and what is abnormal. Anyone who has a PSA test should discuss the results with a physician. The American Cancer Society says that a PSA level above 10.0 ng/ml indicates a more than 67 percent chance that a man has prostate cancer. PSA levels in between these two values may indicate benign conditions, but there is also a 25 percent chance that a man with a PSA level ranging from 4.0 to 10.0 ng/ml has prostate cancer.

There are variations on the PSA test that give more information about a man’s risk for prostate cancer. PSA velocity is a measure of PSA levels over time. If a man’s PSA increases significantly over two or three years, it is more likely that he has prostate cancer than a benign condition. If the PSA velocity increases quickly, the man might have a particularly aggressive form of prostate cancer. PSA doubling time provides similar information, except it is a measure of how quickly PSA doubles. Physicians also consider PSA density when determining a man’s cancer risk. Men with larger prostate glands tend to produce more prostate-specific antigen. PSA density compares the concentration of PSA in the blood with the volume of the prostate gland.

There are some factors that can alter PSA test results even if a prostate problem is not present. Any rigorous physical activity that affects the prostate can cause PSA levels to increase temporarily. If a man has had a prostate biopsy or resection of the prostate, PSA levels will be significantly increased. The PSA test should not be done until six weeks after the procedure to ensure accuracy. Some drugs used to treat cancer, such as methotrexate and cyclophosphamide, may also affect PSA levels. Because so many factors can alter PSA levels, many doctors will recheck any abnormal results before recommending a course of action. This can prevent the unnecessary surgery and complications associated with prostate cancer misdiagnosis.

Disease Detection

It is important to note that the PSA test does not detect all forms of prostate cancer. Some cancer cells do not produce excess prostate-specific antigen, so a PSA test will not always reveal an abnormality.

The prostate-specific antigen test (PSA test) helps determine the amount of a special protein in the blood. The protein is produced by a small gland in the male reproductive system known as the prostate. Low amounts of PSA in the blood do not usually indicate a problem, but [...]]]> Who Should have a PSA Test?

The prostate-specific antigen test (PSA test) helps determine the amount of a special protein in the blood. The protein is produced by a small gland in the male reproductive system known as the prostate. Low amounts of PSA in the blood do not usually indicate a problem, but elevated amounts of this protein can help diagnose prostate infections, prostate enlargement and prostate cancer.

Testing Recommendations

Men who have an increased risk of prostate cancer should get the PSA test and an annual digital rectal exam. The rectal exam can help a physician identify abnormal changes in the prostate gland. Men over the age of 50 have an increased risk for this type of cancer, with most prostate cancer found in men who are at least 65 years of age. Physicians start offering PSA testing when a man turns 40 and make the testing available until a man’s life expectancy is 10 years or fewer. Once life expectancy is at this stage, the likelihood of developing a type of prostate cancer that would cause serious complications is greatly reduced. Since African-American men have an increased risk of prostate cancer, they should undergo this blood test. Consumption of a high-fat diet, exposure to industrial solvents and a family history of prostate cancer are also reasons to get this test.

The screening recommendations for this type of cancer vary from one organization to the next. The American Urological Association recommends a baseline PSA test at the age of 40. The AUA also encourages men to discuss the risks and benefits of this test with their physicians. The American Cancer Society recommends that PSA testing start at 50 years of age unless a man has an increased risk of prostate cancer. The age recommendation is 45 for a man with a high risk of prostate cancer and age 40 for a man with a very high risk of prostate cancer. Someone who had several relatives with prostate cancer is in the high-risk group. Several major organizations do not recommend PSA screening. According to the Centers for Disease Control and Prevention, there is no sufficient evidence to indicate a need for PSA testing. The U.S. Preventive Services Task Force actually recommends against the screening in healthy men. USPSTF says that PSA testing offers no real benefit for men who are not at an increased risk for prostate cancer.

Test Limitations

Although the PSA test can help detect cancer in some men, the test has some limitations. It is not necessarily a life-saving test because it can help detect small tumors that pose very little risk for death. False positives are also a concern for men who undergo this test. This is when a man has an increased PSA level and does not have cancer. The presence of an increased PSA level can lead to unnecessary tests and surgical procedures. False negatives are another concern related to PSA testing. A false negative is when a man has prostate cancer, but his PSA level is normal. Without additional tests, the cancer remains undetected and may have the opportunity to spread to other parts of the body. There is a lot of controversy surrounding the use of this test as a screening tool for prostate cancer because it is not known if the benefits of the test outweigh the risks of additional diagnostic tests and treatments. If a physician orders a prostate biopsy based on the results of the PSA test, the biopsy could cause complications such as infection and bleeding.

Making a Decision

The decision to get a PSA test is a very personal one and should only be made after a detailed discussion with a physician. A man with no risk factors for prostate cancer may find that the potential risks of PSA screening outweigh the possible benefits of the test. Those who have one or more risk factors for this type of cancer may decide to get the test to ease their concerns about developing prostate tumors. If a PSA test reveals an elevated amount of PSA in the blood, a doctor will recommend additional testing to confirm or rule out the presence of prostate cancer.

The PSA test determines the amount of prostate-specific antigen, a protein, in the blood. All men have low levels of this protein in their bloodstreams, but increased levels of PSA can indicate the presence of issues affecting the prostate gland. In some cases, an elevated PSA level indicates [...]]]> Why is the PSA Test Useful?

The PSA test determines the amount of prostate-specific antigen, a protein, in the blood. All men have low levels of this protein in their bloodstreams, but increased levels of PSA can indicate the presence of issues affecting the prostate gland. In some cases, an elevated PSA level indicates the presence of prostate cancer. The PSA test, along with a digital rectal exam and other diagnostic tests, can help physicians determine the best plan of action for treating men who have the signs and symptoms of prostate problems.

Symptoms of Prostate Problems

The prostate gland wraps around the urethra, the tube that carries urine from the bladder to the outside of the body. This walnut-sized gland produces a fluid that mixes with the semen and carries sperm through the reproductive system. When the prostate gland is inflamed, infected or affected by disease, the problem can cause increased urinary frequency, trouble urinating, pain while urinating, fever, difficulty starting the urine stream, painful ejaculation, fatigue and chills. The PSA test can be a useful tool for determining if these symptoms indicate the presence of an infection or a more serious problem.

Prostatitis

Prostatitis is a condition that causes inflammation and swelling of the prostate gland. In some cases, it is caused by a bacterial infection, but other cases have no known cause. Symptoms of this condition include flu symptoms, difficulty urinating, painful urination and pelvic pain. People with nervous system disorders, immune system disorders and injuries to the prostate have an increased risk of prostatitis. The PSA test is useful for people with prostatitis because it can help physicians diagnose the condition early and treat it as soon as possible. Without proper treatment, prostatitis can lead to epidydimitis, abnormalities of the semen and the spread of bacteria to the blood. Once a PSA test helps diagnose prostatitis, antibiotics, pain relievers and alpha-blockers may lessen the symptoms and eliminate any bacteria in the prostate gland.

Benign Prostatic Hypertrophy

Benign prostatic hypertrophy (BPH) refers to enlargement of the prostate gland. This is not a cancerous condition, but it can cause bothersome symptoms. More than 90 percent of men over the age of 90 have some form of prostate enlargement, but younger men can also develop BPH. Signs and symptoms of this condition include incontinence, increased nighttime urination, inability to urinate, painful urination, weak urine stream, bloody urine and delayed started of the urine stream. Fewer than 50 percent of men with BPH have these symptoms, however. The PSA test is useful for diagnosing BPH because it can help rule out prostate cancer and other conditions affecting the prostate. There are several treatment options for this condition. For mild cases of BPH, avoiding caffeine and alcohol can help ease some of the symptoms. Pelvic strengthening exercises can help men with BPH better control their urinary function. If these self-care measures do not help, antibiotics, alpha-1 blockers and finasteride can treat the underlying cause of the BPH.

Prostate Cancer

Prostate cancer starts in the prostate and, without treatment, can spread into nearby organs. This type of cancer is the most common cause of death from cancer in men who are 75 and older. Several groups of men are at an increased for this type of cancer. They include men over the age of 60, men with a family history of prostate cancer, African-American men, men who are exposed to industrial chemicals, farmers, men who eat a diet high in saturated fat, and men who abuse alcohol. Because the symptoms of prostate cancer are similar to those of BPH and prostatitis, a delay in diagnosis is possible. In men who have urine leakage, bloody urine and other urinary symptoms, the PSA test can determine if a man might have cancer. In men with PSA levels above 10.0 ng/ml, there is a significant chance that cancer is present. The only way to confirm a diagnosis of prostate cancer is to perform a biopsy on the prostate. When a biopsy is performed, the pathologist reports the results using a Gleason grade and a Gleason score to indicate the severity of the cancer.

Low-grade prostate cancers have Gleason scores of 2 to 4. Intermediate cases have Gleason scores of 5 to 7. 2-4 is extremely rare and 5-6 are considered low currently.  Scores of 8 to 10 indicate high-grade cancer. In addition to the PSA test and prostate biopsy, bone scans and CT scans can help determine if the cancer has spread to other pelvic organs. Men with prostate cancer may have repeat PSA tests to determine if the treatments used are effective. Some of the treatments used for this type of cancer include surgery, hormone therapy and radiation therapy. These treatments can cause long-term complications and may affect sexual function or cause incontinence.