Prostate Specific Antigen (PSA) Test is a blood test that measures the amount of prostate specific antigen (PSA) in blood. It is important to understand what PSA is.
Prostate Specific Antigen or PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells. It is normal for all men to have a small amount of PSA in their blood, and this amount rises as you get older. A raised PSA level may suggest you have a problem with your prostate, but not necessarily cancer.
What can PSA test suggest?
A raised PSA level can be a sign of a problem with prostate. This could be
- An enlarged prostate
- Inflammation or infection of the prostate called prostatitis
- Prostate cancer
What conditions can cause raised PSA level?
There are many causes which contributes to elevated Prostate Specific Antigens.
- Urine infection: So it suggested that if anyone has urine infection then your will need to wait until the infection has cleared up-around four to six weeks.
- Vigorous exercise: vigorous exercise especially cycling, in the 48 hours before PSA test can result in raised PSA level.
- Any sexual activity 48 hours before a PSA test, can raise PSA level but this is just temporary rise.
- If any prostate biopsy is done in the six weeks before a PSA test, this could raise PSA level.
- Some medicines like 5-alpha-reductase inhibitors to treat an enlarged prostate, such as finasteride (Proscar) or dutasteride (Avodart) can reduce PSA level.
- If catheter is inserted for operations on bladder or prostate this could raise PSA level.
PSA test and prostate cancer
- A raised PSA level can be a sign of prostate cancer. But many men with a raised PSA level don’t have prostate cancer. And some men with a normal PSA level do have prostate cancer.
- Prostate cancer can be seen in people: Aged 50 or over
- Have a genetic disposition like if father or brother has had it.
What actually happens in PSA test?
A sample of blood is taken and sent to a laboratory to be tested. The amount of PSA in blood is measured in Nano grams per milliliter of blood.
What will the test results tell?
- A PSA test alone can’t tell whether a person has prostate cancer, as other things can affect PSA level.
- It’s normal to have a small amount of PSA in blood, and the amount rises as a person gets older.
A normal PSA level is less than:
Age (Years) Range (ng/mL)
- 40 to 49 0 to 2.0
- 50 to 59 0 to 3.0
- 60 to 69 0 to 4.0
- 70 to 79 0 to 5.5
A very high PSA level normally means that a man has prostate cancer. But if PSA level is only slightly high for age, then other tests are necessary to find out if there is a problem.
Advantage of PSA Test
- A PSA test can help pick up prostate cancer before any symptom.
- A PSA test may help to pick up a fast-growing cancer at an early stage when treatment may stop the cancer spreading and causing problems.
- Slow-growing prostate cancer might not need treatment. It may just need regular check-ups, including PSA tests, to keep an eye on cancer. This can avoid or delay the side effects of treatment.
- Having regular PSA tests could be helpful for men who are more at risk of prostate cancer. This can help spot any changes in PSA level, which might be a sign of prostate cancer.
Disadvantages of PSA Test
- It may also happen that a person has raised PSA level, even if he does ‘not have prostate cancer. Many people have a raised PSA level even they don’t have prostate cancer.
- If anyone has raised PSA level it may further tests, including a biopsy. The biopsy has some risks, such as pain, infection and blood in the urine and semen.
- Sometimes persons with prostate cancer can also have normal PSA level.
PSA testing often leads to further testing and treatment. If a person has abnormal PSA test most doctors will recommend a prostate biopsy. This is a simple procedure which a involves removing a small piece of prostate with a thin needle.
What happens if the PSA is high?
There are usually three main possibilities after a PSA test:
- PSA level is not raised: no immediate further action is needed.
- If PSA level is slightly raised: Some further tests, including follow-up of PSA is needed.
- PSA is definitely raised: specialist advice in needed.
In India, the cost of PSA test is about Rs.600.