PSA testing and prostate cancer: Advised for men aged 50 and above, without symptoms of prostate disease

24 Jun 2022

PSA testing and prostate cancer: Advised for men aged 50 and above, without symptoms of prostate disease



Prostate-specific antigen (PSA) is a specific protein that is produced by cells (Both normal and cancer) in the prostate gland. The PSA test measures the level of PSA present in the blood and is reported as Nanograms of PSA per milliliters. Doctors and professionals encourage annual PSA screening for prostate cancer from the age of 50. The PSA level increases in prostate cancer.

Although the PSA test is not a definitive test for prostate cancer, and elevated PSA levels cannot confirm the presence of cancer, as it can fluctuate at different times throughout life, it will indicate a need for further testing.

Through this article, we will walk you through the information on prostate cancer, what is PSA test, its need after 50, why is PSA test done and and its results.


Feel free to skip ahead if one topic catches your eye:

  1. What is Prostate Cancer and Its Symptoms?
  2. Why is it advised for men to take PSA tests after 50.
  3. PSA Test and Prostate Cancer.
  4. Prostate-specific antigen Test Results.
  5. FAQs



1. What is Prostate Cancer and Its Symptoms?


The cancer of the prostate gland present in males is called prostate cancer. The prostate is a walnut-shaped gland located between the penis and bladder and it produces the seminal fluid that aids in nourishing and transporting the sperms.

Prostate cancer is one of the most common types of cancer and differs in its occurrence. Some are confined to the prostate and grow slowly. These do not cause much harm and need minimal or no treatment. According to the World Health Organization, 2020 statistics, the incidence of prostate cancer ranks second among all malignant tumors in men, worldwide. While others may be aggressive and spread quickly, it needs treatment. It is rare in men under 50 and the risk increases with age.

Although in treatable stages, Prostate cancer may not show any signs or symptoms, during later stages, when it grows large to exert pressure on the urine tube, the prostate cancer symptoms may be associated with:

  • Urinating more frequently.
  • Need to rush to pee.
  • Taking more time to urinate.
  • Less force in the urine stream.
  • Trouble starting to pee.
  • Feeling as if the bladder is not fully empty.
  • Blood in the urine.
  • Blood in the semen.
  • Bone pain.
  • Loss of weight.
  • Difficulty in an erection.


2. Why is it advised for men to take Prostate-specific antigen tests after 50.


PSA test is generally advised for men over 50 because:

  • The research suggests that prostate cancer is most common between the age of 50 to 65 years and especially among black ethnic men having a family history.
  • It helps to assess the health of the prostate gland and to know its progression and to check if there is a risk of developing prostate cancer in the future.
  • The PSA test will help to detect prostate cancer before any symptoms arise so that it can be treated successfully.
  • If the PSA test is done, it can pick up fast-growing cancer at an early stage, before it spreads to other parts, and thus prevent further problems.
  •  Apart from Prostate cancer, other conditions like noncancerous conditions and inflammation of the prostate are also detected via the PSA test.

Before deciding to take the Prostate-specific antigen test, always discuss the potential risks and benefits with your doctor. 


3. PSA Test and Prostate Cancer.


There is no single, definitive test for prostate cancer. Your doctor will assess your risk based on various factors, like age, family history, ethnic group, etc., and accordingly, advise various tests.

The PSA test is used to check the PSA levels by examining your blood sample in the lab.

  • Before the test, you will be asked to stop certain medications and supplements, so let your doctor know about all of them.
  • The nurse or technician will draw blood and send it to the lab for diagnosis.
  • The PSA levels will be analyzed in the lab and reported in a few days.

In case, there are elevated levels of PSA in your blood, and the doctor after analyzing all factors, believes that your PSA levels need further investigation, he/ she will prescribe other tests like:

    • DRE (Digital rectal examination): A gloved finger is inserted into the rectum to check the prostate gland.
    • Ultrasound: A small-sized probe is put into the rectum and images of the prostate are obtained.
  • MRI Prostate: Done to get a more detailed picture of the prostate.
  • Prostate biopsy: This is a definitive test for prostate cancer, wherein a small sample of the prostate tissue is taken and examined with the help of a microscope to assess the type and the severity of the prostate cancer.



 4. PSA Test Results.


The PSA test will measure the amount of PSA molecules in your blood and in Nanograms of PSA per milliliter of blood(ng/mL)

There are no set standards of a normal PSA result, but all men have some PSA in their blood. Usually, if the PSA levels are more than 4ng/Ml, there may be a risk of prostate cancer, but it can be raised due to other reasons also like:

  • A urinary tract infection.
  • Recent heavy exercise.
  • Stimulation of prostate due to recent ejaculation.
  • Other prostate problems like enlarged prostate etc.

Also, a lower Prostate-specific antigen level doesn’t guarantee that you are not suffering from cancer. Your doctor will look into other factors  like how your prostate works and what were your PSA levels before.

Some other ways of reading a PSA test:

Based on how fast the PSA goes up: This is done through a series of PSA tests because the PSA normally goes up with age at a slower pace. A fast growth rate may be a sign of cancer.

Based on size: The larger prostate may have higher PSA levels. Therefore, the volume of the prostate is measured through ultrasound and then the PSA number is divided by the volume. Higher density may indicate a risk of cancer.

5. FAQs

1. What is the normal PSA value?

PSA value between 2.5 to 4 ng/ml is considered normal for most men, but depends on factors like age, size of the prostate, activities of the individual like heavy exercise, etc. Each individual may have a different normal value, which the doctor has to assess.


2. Is fasting required to take a Prostate-specific antigen test?

No, fasting is not required for a PSA test.


3. Are there any potential harm from the PSA test?

Yes, some of the disadvantages include:

  • Sometimes it detects even small tumors which do not pose any harm, throughout the lifetime. This  is called over-diagnosis and treating these is called overtreatment which may cause unnecessary exposure to radiation and chemicals.
  • Many false-positive results are seen, which means it shows elevated levels even when there is no cancer. This increases unnecessary anxiety and ill effects of other procedures like biopsy which may have side effects of pain, infections, and bleeding.



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