What is a PSA test?

Prostate-specific antigen (PSA) is a protein produced by both cancerous (malignant) and noncancerous (benign) prostate tissue. PSA helps liquefy the semen. A small amount enters the bloodstream. Cancer cells usually make more PSA than do benign cells, causing PSA levels in your blood to rise. However, determining what a high PSA score means can be complicated. Besides the PSA number itself, your doctor will consider a number of other factors to evaluate your PSA scores:

* Your age

* The size of your prostate gland

* How quickly your PSA levels are changing

* Whether you're taking medications that affect PSA measurements, such as finasteride (Propecia, Proscar), dutasteride (Avodart) and even some herbal supplements

When elevated PSA isn't cancer

While high PSA levels can be a sign of prostate cancer, a number of conditions other than prostate cancer also can cause PSA levels to rise. These other conditions could cause what's known as a "false-positive" — meaning a result that falsely indicates you might have prostate cancer when you don't. Conditions that could lead to an elevated PSA level in men who don't have prostate cancer include:

* Benign prostate enlargement (benign prostatic hyperplasia)

* A prostate infection (prostatitis)

* Other less common conditions

False-positives are common. Only about one in four men who have a positive PSA test turns out to have prostate cancer.

Why you Should Consider a Prostate Cancer Psa Test Today

Prostate Cancer kills if allowed to grow. If ever there was a good reason to have a simple blood test, this is it. The Prostate cancer PSA (Prostate Specific Antigen) test is one of the tests given to determine if cancer cells are present in an otherwise healthy prostate. It is a simple blood test to help doctors diagnose and identify the existence of prostate cancer.

The PSA test, although considered a prostate specific test is not really an absolute definitive test for the cancer. Depending on the research conducted, the PSA test is known to be somewhere between 85 and 95% accurate in identifying prostate cancer.

While an elevated PSA test may suggest the presence of prostate cancer, it's not an absolute. If however you have an elevated result, your doctor will probably want to do additional testing for a more complete and accurate assessment of the potential cancer. The last thing you want to do is to allow prostate cancer to grow beyond the prostate gland.

The good news is that BPH or Benign Prostatic Hyperplasia, better known as an enlarged prostate can also elevate the PSA test results. Even Prostatitis and Lower Urinary Tract symptoms can show elevated levels of PSA so if you have an elevated test result don't panic! A normal result from a PSA test, doesn't guarantee that your free from cancer, nor does a higher than normal result means you do have cancer

It's critical that you follow your doctor's lead in regard to dealing with the Prostate Specific Antigen test results. The results are an indication in a tool only to develop a complete diagnosis. To complicate matters more, PSA levels can also increase with age. Oh and the relative size of your prostate also plays a factor in interpreting the results.

Remember that as many as two out of three people with elevated the PSA readings DO NOT have a malignancy

Here's a quick list of the benefits and reasons why you should consider getting a PSA test

1. It's possible to detect a cancerous condition before any symptoms are known

2. Early detection catches prostate cancer before it is spread increasing the chances of a complete cure

3. The PSA blood test has been recognized as a contributing factor that has significantly reduced the number of prostate cancer death

The PSA test also delivers a false positive, which is a normal PSA level in about 20% of the time. It is still recognized as a good indicator of potential cancerous conditions and should be taken seriously. A 2005 Harvard study indicated that men having an annual PSA test were almost 3 times LESS likely to die of prostate cancer than men who didn't bother with the test. So the best reason to have the test is that without it, you greatly increase the chances of dying from prostate cancer!

What if the test results show a rising PSA level after treatment for prostate cancer?

A man should discuss rising PSA test results with his doctor. Doctors consider a number of factors before recommending further treatment. Additional treatment based on a single PSA test result is often not recommended. Rather, a rising trend in PSA test results over a period of time combined with other findings, such as an abnormal DRE, positive prostate biopsy results, or abnormal CT (computed tomography) scan results, may lead to a recommendation for further treatment.

According to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology for Prostate Cancer (4), additional treatment may be indicated based on the following PSA test results:

* For men who have been in the watchful waiting phase—their PSA level has doubled in fewer than 3 years or they have a PSA velocity (change in PSA level over time) of greater than 0.75 ng/mL per year, or they have a prostate biopsy showing evidence of worsening cancer (4).

* For men who have had a radical prostatectomy (removal of the prostate gland)—their PSA level does not fall below the limits of detection after surgery or they have a detectable PSA level (> 0.3 ng/mL) that increases on two or more subsequent measurements after having no detectable PSA (4).

* For men who have had other initial therapy, such as radiation therapy with or without hormonal therapy—their PSA level has risen by 2 ng/mL or more after having no detectable PSA or a very low PSA level (4).

Please note that these are general guidelines. Prostate cancer is a complex disease and many variables need to be considered by each patient and his doctor.

What is a normal PSA level?

Most authorities agree that if you have a PSA greater than 4 ng/ml, you should have further investigations. Some suggest that if your PSA is greater than the 'normal for age' range shown in Table 1, or if it is rising rapidly, it should be investigated.

Depending on your age and family history, your doctor may then refer you directly to a Urologist, or may repeat the test before referring you for further investigation.

If cancer is present, the level of PSA in the blood rises as the tumour grows. This means that small rises in PSA are found in association with small tumours which may be still confined to the prostate gland (localised). PSA levels of 10ng/ml or less have the best chance of being localised 3. The PSA level and the cancerous characteristics of the tumour cells themselves (called "grade") can indicate the risk that a tumour has grown beyond the prostate.

If cancer is present, the rate at which the PSA level increases over a series of tests (called PSA velocity) also gives information about the risk that cancer will recur after treatment

Why is the PSA test controversial in screening?

Using the PSA test to screen men for prostate cancer is controversial because it is not yet known for certain whether this test actually saves lives. Moreover, it is not clear that the benefits of PSA screening outweigh the risks of follow-up diagnostic tests and cancer treatments. For example, the PSA test may detect small cancers that would never become life threatening. This situation, called overdiagnosis, puts men at risk of complications from unnecessary treatment.

The procedure used to diagnose prostate cancer (prostate biopsy) may cause harmful side effects, including bleeding and infection. Prostate cancer treatments, such as surgery and radiation therapy, may cause incontinence (inability to control urine flow), erectile dysfunction (erections inadequate for intercourse), and other complications. For these reasons, it is important that the benefits and risks of diagnostic procedures and treatment be taken into account when considering whether to undertake prostate cancer screening.