PSA or prostate specific antigen is a molecule secreted by both normal and cancerous cells of the prostate gland. PSA is commonly linked to prostate cancer because cancerous tissue can increase PSA levels. Because of this, a prostate cancer screening test usually consists of the measurement of the PSA level in the blood. High PSA levels may indicate prostate cancer, however, one should know that lower levels of PSA in the blood do not always indicate a healthy prostate and high blood levels of PSA do not always indicate cancer.
So, what do levels of PSA in the screening test mean? Is it necessary to know your PSA level to maintain a healthy prostate? Here are the five things you should know about PSA:
A high level of PSA does not always indicate prostate cancer
Non-cancerous enlargement of the prostate usually results in the increased production of PSA. Some bacterial or other microbial urinary tract infections can also cause increased PSA production. Various studies demonstrate that certain forms of stress in the prostate area such as ejaculation or micro injuries caused by cycling can also cause temporary spikes in PSA levels.
If a screening test indicates higher PSA levels in your blood, your physician will want to exclude these common causes (mentioned above) by taking several PSA tests over the course of a year.
Screening is important, however, not for everyone
Detection of higher PSA levels can lead to the early detection of prostate cancer, which is usually asymptomatic, i.e. prostate cancer has few to no warning signs. Screening is most beneficial for men above the age of 50. Some men have a higher risk for prostate cancer and may therefore benefit from screening at earlier ages, such as Africans and those having a positive family history of the disease.
However, as the disease usually progresses slowly, the risks of screening tests may be greater than the benefits for men less likely to have prostate cancer. PSA screening can lead to overtreatment. There are risks and side effects from invasive procedures such as punch biopsies, anxiety caused by multiple biopsies, and complications of radical treatments like surgery or radiation therapy.
“High” is relative
A PSA level above 4 (i.e., 4 nanograms per milliliter of blood) is usually considered as high, however, there are several factors that can affect the PSA level (age, physical status etc.). This underscores the importance of evaluating the case of each patient before deciding to perform a biopsy.
While it is a broad consideration that raised PSA levels are generally indicative of prostate cancer, “normal” or “high” do not have fixed definitions. Each case needs to be individually evaluated.
A single test does not tell the whole story
One screening test is not sufficient to make a definitive diagnosis. For example, a man whose PSA levels go from 0.6 to 1.8 in a few weeks or months is of greater concern than someone who has had consistent, slightly elevated PSA level for months or years.
Men with prostate hyperplasia (enlarged prostate) usually produce more PSA. In addition to the PSA rate (rate of change in PSA levels), the amount of PSA production relative to the size of the prostate (PSA density) can help determine whether the results of the screening test are of greater concern or not. So a level of 6 in a screening test is less disturbing in someone with prostate hyperplasia than for men with a normal sized prostate.
Prostate health tips are not well-researched
So, what can be done if a man has an elevated PSA level? The first step is to understand the issue, and then to target it. Many physicians suggest a biopsy after the detection of a rising PSA. However, a standard punch biopsy is not as accurate as most people might think. It is a bit like trying to find a needle in a haystack. An MRI of the prostate is much more sensitive and more specific. This non-invasive imaging method can show you what your prostate looks like; without the need for any surgical procedure.