Prostate-specific antigen (PSA) is a protein that is produced by the cells located in the prostate gland. PSA is found in the bloodstream and the PSA blood test measures it.  The PSA test has been approved by the FDA to help detect prostate cancer in men. The FDA recommends a digital rectal exam in conjunction with the PSA starting at the age of 50 years old.

PSA testing can also be used to monitor a patient and determine the success or failure of treatment.  Cancer is suspected when the PSA levels are found in high quantities in the blood. There are however other possible scenarios that can lead to higher levels of PSA though.

 

 

The PSA test shows the level of PSA within the blood stream. The levels are reported in nanograms per milliliter recorded as ng/mL. The normal value for total PSA is considered to be less than 4.0 ng/ml (Nano grams per milliliter of blood).  There are some professionals that feel that this level should be lowered to 2.5 ng/ml in order to detect more cases of prostate cancer. Some believe that by lowering the levels it would lead to over diagnosis and do more harm than

good. 

 

Those with level between 4.1 and 9.9 are likely to have prostatic cancer. A recent study notated by the National Cancer Institute suggested that 65 to 75% of men that had a level higher than 4.1 had cancer, but with a level less than 9.9 did not. The reasons for the fluctuations are other disorders such as Prostatitis, or the inflammation of the prostate, or Hyperplasia the enlargement of the prostate can cause fluctuations in the PSA levels.

 

There are other factors and reasons that the PSA can fluctuate in the bloodstream and doesn’t necessarily signify cancer. Two common causes of high PSA levels are enlargement of the prostate (benign prostatic hypertrophy) and infection in the prostate. The level can also rise after ejaculation or catheterization. 

Other factors that sometimes cause fluctuations are certain types of medications such as those for baldness.

 

 

 

 

Using the PSA test to screen men for prostate cancer is controversial.  An example might include an individual that had a small level of cancer, yet would never become life threatening or problematic. This would lead to over diagnosis and could risk other complications or health concerns from unnecessary treatments.

 

However, the benefits of early detection of prostate cancer are clear when the disease is life threatening.  Research continues for the PSA test, as they are working to improve the testing, levels and the early detection of prostate cancer.  Currently the American Urological Association (AUA) continues to recommend routine PSA testing and stresses the importance of establishing a baseline PSA level at or before the age of 40.

 

 

The PSA test may also be used as a monitoring tool to help determine the effectiveness of treatment if prostate cancer has been diagnosed.  If the PSA is found to be abnormal, then the doctor may choose to follow up this testing with a prostate biopsy and possibly imaging tests, such as an ultrasound, CAT scan, or MRI.

The American Cancer Society recommends that doctors offer total PSA tests annually to all men, beginning at age 50 and to those with an increased risk of prostate cancer, such as American men of African descent and men with a family history of the disease, beginning at age 40 or 45.