PSA Test for Prostate Cancer Diagnosis: Things Men Need to Know About It

Dr. Ankita Pal Singh, Profit Centre Head and Chief of Labs, Neuberg Diagnostics APTS

Prostate cancer is one of the most common types of cancer that affects men. Early detection plays a crucial role in improving the chances of successful treatment. One of the tools commonly used for prostate cancer screening is the Prostate-Specific Antigen (PSA) test. Let’s explore what men need to know about the PSA test, its benefits, limitations, and considerations.

What is the PSA test?

The PSA test measures the protein level called Prostate-Specific Antigen in the blood. The prostate gland produces PSA, and elevated levels can indicate the presence of prostate cancer or other prostate conditions. The test involves a simple blood draw, and the results are usually available within a few hours.

What are the normal levels of serum PSA?

There is no specific normal or abnormal level of PSA, and levels can vary from person to person. Generally, a PSA level below 4.0 nanograms per milliliter (ng/mL) is considered normal, but higher levels do not always indicate cancer.

Factors Affecting PSA Levels:

PSA levels can be influenced by various factors, including age, prostate size, medications, and recent sexual activity.

Benefits of the PSA test:

Early detection: The PSA test can help detect prostate cancer in its early stages, even before symptoms develop. Early detection allows for timely treatment and potentially better outcomes.

Monitoring: For men diagnosed with prostate cancer, the PSA test can be used to monitor the progression of the disease and the effectiveness of treatment.

Risk assessment: PSA levels can also help assess the risk of developing prostate cancer in the future. Higher baseline PSA levels may indicate a higher risk, prompting closer monitoring or additional diagnostic tests.

Limitations and considerations:

False positives: Elevated PSA levels can be caused by conditions other than prostate cancer, such as benign prostatic hyperplasia (BPH) or prostatitis. This can lead to false-positive results, causing anxiety and potentially unnecessary follow-up tests or biopsies.

Inconclusive results: Sometimes, PSA test results may be inconclusive, requiring further testing or monitoring to make an accurate diagnosis. Inconclusive or borderline PSA results require further blood tests i.e free PSA along with the total PSA to make an accurate diagnosis.

Considerations before undergoing the PSA test:

Age and risk factors: The decision to undergo PSA testing should be based on an individual’s age, family history of prostate cancer, and overall health. However, the test should be made mandatory for men above 50 and a part of the preventative health up. Guidelines may vary, but generally, discussions about PSA testing start around the age of 50 for most men, while those at higher risk may consider testing earlier.

Follow-up procedures: If PSA levels are elevated or concerning, further diagnostic tests, such as an ultrasound of the prostate or prostate biopsy may be recommended to confirm or rule out prostate cancer.

The PSA test can be valuable for prostate cancer screening and monitoring. It provides an opportunity for early detection and intervention, improving treatment outcomes. However, it is important to recognize the limitations of the test, including the possibility of false positives. Individualized discussions with healthcare providers, considering age, risk factors, and personal preferences, can help men make informed decisions about undergoing the PSA test and subsequent follow-up procedures. Regular check-ups and open communication with healthcare professionals remain vital for maintaining prostate health and overall well-being.