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Prostate-Specific Antigen (PSA) Test

Prostate-specific antigen (PSA) is a protein produced by cells of the prostate gland. The PSA test measures the level of PSA in the blood. The doctor takes a blood sample, and the amount of PSA is measured in a laboratory.
Doctors often use the PSA test as prostate cancer screening tests; together, these tests can help doctors detect prostate cancer in men who have no symptoms of the disease.

Doctors’ recommendations for screening vary. Some encourage yearly screening for men over age 50, and some advise men who are at a higher risk for prostate cancer to begin screening at age 40 or 45. Others caution against routine screening. Although specific recommendations regarding PSA screening vary, there is general agreement that men should be informed about the potential risks and benefits of PSA screening before being tested.

Thus, there is no specific normal or abnormal PSA level. In addition, various factors, such as inflammation (e.g., prostatitis), can cause a man’s PSA level to fluctuate. It is also common for PSA values to vary somewhat from laboratory to laboratory. Consequently, one abnormal PSA test result does not necessarily indicate the need for a prostate biopsy.
A man should discuss an elevated PSA test result with his doctor. There can be different reasons for an elevated PSA level, including prostate cancer, benign prostate enlargement, inflammation, infection, age, and race. If no symptoms to suggest cancer are present, the doctor may recommend repeating DRE and PSA tests regularly to watch for any changes. If a man’s PSA level has been increasing or if a suspicious lump is detected during a DRE, the doctor may recommend other tests like urine test, imaging tests, CT Scan, MRI, ultrasound to determine if there is cancer or another problem in the prostate. If cancer is suspected, a biopsy is needed to determine whether cancer is present in the prostate.

Limitations of the PSA test

– Detecting tumors does not always mean saving lives : When used in screening, the PSA test can detect small tumors.
– False-positive tests : False-positive test results (also called false positives) occur when the PSA level is elevated but no cancer is actually present.
– False-negative tests : False-negative test results occur when the PSA level is in the normal range even though prostate cancer is actually present.

Need To Know

An elevated PSA does not automatically mean a man has prostate cancer. Conditions other than cancer, including an infection or a benign enlargement of the prostate, can result in higher-than-normal PSA levels.The PSA test is not foolproof.

Nice To Know

Recent studies have shown that a variation of the PSA test, called the percent-free PSA test, may be better at detecting prostate cancer.

The percent-free PSA looks at how much PSA circulates alone (free) in the blood and how much is clinging to other proteins. A low percentage of free PSA, even if the total PSA is not especially high, may mean that prostate cancer is more likely.
The percent-free PSA test is not available at all testing facilities.

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