Prostate Specific Antigen Test (PSA): How It Can Detect Prostate Cancer

01 Apr 2022

Prostate Specific Antigen Test (PSA): How It Can Detect Prostate Cancer

Prostate cancer is globally the second most frequent malignant disease found in men. And overall, it is the fourth most common form of cancer. Like the other forms, this form of cancer can also be cured if detected early on. 

There are several tests to recognize and diagnose prostate cancer. One of those methods, the prostate specific antigen test, helps in the early detection of the disease. However, the PSA test is not usually preferred by doctors unless needed as it has considerable risk factors. Most of the time this screening method is done to monitor the progress of pre-diagnosed prostate cancer or to inspect if cancer came back after complete treatment and cure. 

Below is a detailed account of what a prostate specific antigen test means, how to understand PSA levels, how to prepare yourself for the test, and what to expect next. 

Table Of Contents

What Is A PSA Test?

How To Prepare Yourself For A PSA Test?

PSA Test Level Result

Reasons Of Raised PSA Levels

What Other Tests Doctors Suggest To Detect Prostate Cancer?

Takeaway

What Is A PSA Test

PSA’s full form is Prostate Specific Antigen. It is a protein produced by the cells, be it normal or malignant, of the prostate, a tiny gland present in men right beneath the urinary bladder. The prostate specific antigen functions as a major component of semen and is produced by the prostate all the time. Hence, PSA is always present in our blood. However, its amount can fluctuate which could be due to some normal chores or diet, or an underlying condition. 

The prostate specific antigen test was approved by the FDA in 1986 and, in 1994, FDA approved the use of Digital Rectal Examination (DRE) along with PSA test to successfully diagnose prostate cancer. 

This means that the prostate specific antigen test alone cannot confirm the disease. It is often followed by other tests to confirm the result. 

How To Prepare Yourself For A PSA Test? 

Now that we have discussed what is prostate specific antigen test, let’s see how to prepare yourself for it. The PSA test is a sensitive procedure and the result can be altered by several factors, increasing the chances of a false positive. The following steps can help you prevent such fluctuations and get accurate results:

  • Inform the doctor if you have any other health condition, or take any over-the-counter or prescribed medications. Certain medicines decrease the PSA levels in the blood. In such a case, the doctor would ask you to stop taking the medicines 24 or 48 hours before the test. 
  • Avoid any strenuous exercise or vigorous physical activity for one or two days before the test. 
  • Avoid ejaculation by any means for 24 hours before the surgery. 
  • Consult with your doctor about other precautions you may need to take before the test. 

PSA Test Level Result

There is no determined prostate specific antigen normal range for an individual. Hence, it can be difficult to determine what the result of a PSA test means

The amount of PSA is measured in nanograms per milliliter (ng/mL) of blood. It is estimated that the PSA level of a healthy 40-50 years old man lies between 0-2.5, while that of a 50-60, 60-70, and 70-80 years old man lies between 2.5-3.5, 3.5-4.5, and 4.5-5.5 respectively. As indicated, the prostate specific antigen levels in the blood rise with age. 

Although low PSA levels are normal, the higher are the PSA levels, the more is the risk of prostate cancer. However, an increased PSA level doesn’t necessarily mean that you have prostate cancer. 

Usually a prostate specific antigen reading higher than 4 indicates the chances of infection but sometimes even reading as high as 20 or 50 can be because of acute infection of the prostate.

In such cases, patients usually have fever, urinary problems and are, most of the time, diabetic.

After seeing the results, if the doctor thinks you might have prostate cancer, they might perform a repeat prostate specific antigen test to confirm the reading, monitor your PSA levels for the next few days, and if the levels keep on rising, prescribe other tests to confirm the disease. 

Reasons Of Raised PSA Levels

Apart from prostate cancer, several other factors lead to the increase in the PSA levels. Some of them are listed below:

  • Benign Prostatic Hyperplasia causes inflammation of the prostate, leading to increased production of PSA. 
  • Prostatitis is usually caused by an infection that leads to the inflammation of the prostate and hence, an increase in prostate specific antigen levels. 
  • Ejaculation
  • Recent biopsy
  • Vigorous physical activity
  • Chemotherapy drugs
  • Anti-inflammatory drugs
  • Non-steroidal drugs
  • Urinary tract infections
  • Fenugreek, pomegranate, etc. 
  • Other drugs like dutasteride and finasteride. 

Some of these factors like prostatitis and BPH can cause a chronic increase in the PSA levels unless they are treated. On the other hand, the others cause a temporary fluctuation in the PSA levels. 

What Other Tests Doctors Suggest To Detect Prostate Cancer? 

As mentioned above, a PSA test does not confirm prostate cancer. Hence, if the doctor suspects any chances of prostate cancer after seeing the results, they would prescribe other tests to confirm it. Some of those tests include:

 

  • Digital Rectal Examination: In this test, the doctor would insert a gloved finger into the rectal area and look for any inflammation, or hard or lumpy areas in the prostate. The procedure is simple and quick. If they detect something, they would order other tests. 

 

  • Imaging Tests: High-resolution imaging tests like MRIs, and ultrasounds help to detect any inflammation or lumps in the prostate. It is a reliable diagnostic method and can easily help the doctor to identify the reason behind increased prostate specific antigen levels. 
  • Prostatic Biopsy: If the other tests indicate the possibility of prostate cancer, a biopsy is the best way for final confirmation. In this process, the doctor would insert a catheter with a hollow needle on its tip through the rectal opening and into the body. The needle is used to take out some cells from the prostate. This sample is then examined by a pathologist under the microscope. 

Takeaway

With over a decade of experience, Dr. Vikram Batra Shah is an expert and renowned urologist in Delhi. He is well versed in endourological and laparoscopic procedures and robotic surgeries. Practicing at The Urethra Clinic, Delhi, Dr. Vikram Batra Shah has a team of expert doctors who ensure to provide every patient a personalized treatment and care. 

The Urethra Clinic is equipped with the state of the art technology, comfort aids, and friendly staff who make the overall experience for the patients comfortable and stress-free.