The test measures the amount of prostate-specific antigen PSA in your blood. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below the bladder in males.
PSA is mostly found in semen, which also is produced in the prostate. Small amounts of PSA ordinarily circulate in the blood. However, many other conditions, such as an enlarged or inflamed prostate, also can increase PSA levels. Therefore, determining what a high PSA score means can be complicated. There is a lot of conflicting advice about PSA testing. To decide whether to have a PSA test, discuss the issue with your doctor, considering your risk factors and weighing your personal preferences.
Prostate cancer is common, and it is a frequent cause of cancer death. Early detection may be an important tool in getting appropriate and timely treatment. Prostate cancer can cause elevated levels of PSA. However, many noncancerous conditions also can increase the PSA level. The PSA test can detect high levels of PSA in the blood but doesn't provide precise diagnostic information about the condition of the prostate.
The PSA test is only one tool used to screen for early signs of prostate cancer. Another common screening test, usually done in addition to a PSA test, is a digital rectal exam. In this test, your doctor inserts a lubricated, gloved finger into your rectum to reach the prostate.
By feeling or pressing on the prostate, the doctor may be able to judge whether it has abnormal lumps or hard areas. Neither the PSA test nor the digital rectal exam provides enough information for your doctor to diagnose prostate cancer.
Abnormal results in these tests may lead your doctor to recommend a prostate biopsy. During a prostate biopsy, samples of prostate tissue are removed for laboratory examination.
A diagnosis of cancer is based on the biopsy results. For those who have already been diagnosed with prostate cancer, the PSA test may be used to:. Medical organizations vary in their recommendations about who should — and who shouldn't — get a PSA screening test. Discussing with your doctor the benefits, limitations and potential risks of the PSA test can help you make an informed decision.
A PSA test may help detect prostate cancer at an early stage. In this article, we look at seven noncancerous causes of high PSA levels, plus other symptoms that may indicate prostate cancer. People who are more than 50 years of age should talk to their doctor about their risk of developing prostate cancer and the benefits and risks of PSA screening for them.
Some data suggest that screening does not improve cancer survival rates and may result in false positive results. The process of diagnosis and treatment may also provide more harm than benefit for men who are older than 70 years. Therefore, it is important to discuss screening options with a doctor based on family and personal medical history. Prostatitis is an inflammation of the prostate and can be a chronic problem. The condition may sometimes occur due to a bacterial infection.
BPH is a common condition in older men. BPH does not increase the risk of cancer, but the symptoms can be similar to prostate cancer. A person with BPH will often experience irritation while urinating. Learn more about BPH here. A recent prostate exam can cause false positives on a PSA test.
Likewise, this can occur after the insertion of a urinary catheter or scope into the urethra. For the most accurate results, a person should wait a few weeks after a medical procedure before undergoing the PSA test. Having a UTI can cause pain during urination, blood in the urine, or an inability to urinate. In most cases, a simple urine test can accurately diagnose a UTI.
Read more on UTIs in men. Running and doing other forms of vigorous exercise a day or two before a PSA test may result in a false positive. People who have scheduled a PSA test should tell their doctors about any prostate symptoms they may be experiencing.
Changes in ejaculation or urination often indicate a problem with the prostate. Rectal pain, abdominal pressure, fever, and signs of an infection may also indicate a prostate issue. This will show whether the cells in the prostate are malignant cancerous or benign non-cancerous.
A biopsy is the only way a firm tissue diagnosis of prostate cancer can be made. If the biopsy is negative, you will probably be offered regular check-ups with more PSA tests to monitor you in the future.
A positive biopsy is the only way to confirm that you have prostate cancer. The cancer grade , which is determined from the biopsy, gives an indication of how fast the cancer is growing. You may be required to have further tests to determine the stage of the cancer. The cancer stage indicates whether the cancer has remained within the prostate gland or has spread outside of the prostate to surrounding areas or other parts of the body.
How your prostate cancer is treated will depend on your PSA results, the grade and stage of the cancer, your symptoms, your overall health and your personal preferences. If there is a low risk that your prostate cancer will cause you harm, you may be offered Active Surveillance. This involves regular testing to check for any changes to the cancer. If the cancer changes you may need treatment.
If your cancer is higher risk, you will be offered treatment. Different treatments come with differing side effect some of which include urinary problems, erectile dysfunction, bowel problems, fatigue, depression and anxiety. PCFA has written to the Commonwealth Government to seek funding support for a five-year review and update of the PSA Test Guidelines, on the basis that the current guidelines remain highly controversial and poorly understood by the majority of Australians.
Moreover, prostate cancer treatment has changed markedly over the past five years, with significant advances in clinical care and a drastic reduction in rates of overdiagnosis and overtreatment. It is therefore timely for us to undertake a comprehensive review of the guidelines and consider the emerging evidence on prostate cancer screening, incidence, and survival in the Australian context.
Investment in a revised set of PSA Test Guidelines and increased public awareness activity holds great potential for improving prostate cancer awareness and survival in Australia.
Visit PCFA for information and support at www. How is PSA measured? What do the results mean? What could affect my PSA level?
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