What Is A Normal Psa Test Result
There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.
However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer . In addition, various factors can cause a mans PSA level to fluctuate. For example, a mans PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugsincluding finasteride and dutasteride , which are used to treat BPHlower a mans PSA level. PSA level may also vary somewhat across testing laboratories.
Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of White men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.
In general, however, the higher a mans PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a mans PSA level over time may also be a sign of prostate cancer.
I Have High Psa Levels: How Do I Find Out If I Have Prostate Cancer
Prostate cancer is the most common form of cancer in men. The first test most doctors use to screen for prostate cancer is the PSA test. A high PSA level can indicate the presence of cancer. But other factors besides cancer can cause an elevated PSA level. If your PSA level is rising, learn more about your options for finding out if you have prostate cancer.
The Role Of Psa In Choosing The Best Treatment
If you have received a diagnosis of prostate cancer, your PSA levels can be used along with the results of other tests and physical exams and your tumors Gleason score to help determine which tests are needed for further evaluation and to decide on the best treatment plan. After treatment has begun, your PSA and other tests will be used to determine how well the treatment is working: The more successful the therapy, the lower the PSA.
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What If My Psa Is High
PSA screening is just the first step, alerting you and your doctor that more testing may be needed. If PSA is only slightly elevated, your doctor may recommend repeating the test a couple of weeks later. From there, other types of tests can help with the decision on whether you need a biopsy, including:
- Digital rectal exam , if not already done
- Free PSA test
- PSA velocity, or the rate of rise over time
- PSA density, or the PSA per volume of prostate
- PSA-based markers
- Other markers, a urinary PCA3 or SelectMDx test
- Magnetic resonance imaging of the prostate
Each time you see your doctor for a checkup, have a conversation about prostate health and prostate cancer screening. PCF recommends that you make a about PSA screening with your doctor, starting at age 45, or age 40 if you have a family history of prostate or other cancers or are Black.
Should Men At Elevated Risk Be Screened More Aggressively
It might sound logical to screen high-risk men earlier or urge men to adopt a healthy lifestyle to lower their risk for prostate cancer, but these areas have not been studied sufficiently. Therefore, physician organizations recommend more research and individualizing decisions about whether to get screened. Meanwhile, some leading organizations have issued recommendations, including:
- The American Urological Association The AUA recommends individualizing decision-making for men younger than age 55 who are high risk because they are African-American or have a positive family history. rel=nofollow> 7)
- The U.S. Preventive Services Task Force The USPSTF largely agrees largely with AUAs position and its 2018 recommendations are based on AUAs evidence review.
- The American Cancer Society The ACS takes this a step further, urging discussion about screening begin earlier for African-American men and men with first-degree relatives who have had prostate cancer.
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How Are Researchers Trying To Improve The Psa Test
Scientists are investigating ways to improve the PSA test to give doctors the ability to better distinguish cancerous from benign conditions and slow-growing cancers from fast-growing, potentially lethal cancers. None has been proven to decrease the risk of death from prostate cancer. Some of the methods being studied include:
There Are Risks To Getting Prostate Cancer Tests And Treatments
If your PSA is not normal, you will probably have a biopsy. The doctor puts a needle through the wall of the rectum and into the prostate to take a few samples. Biopsies can be painful and cause bleeding. Men can get serious infections from biopsies, and they may need hospital care.
Surgery or radiation are the usual treatments for prostate cancer. They can do more harm than good. Treatment can cause serious complications, such as heart attacks, blood clots in the legs or lungs, or even death. In addition, 40 men out of 1,000 will become impotent or incontinent from treatment.
What Factors Can Falsely Elevate Your Psa Level
There are other factors that can affect the PSA level besides prostate cancer. The following conditions can lead to increased PSA levels:
Benign prostate hyperplasia , a condition that commonly develops as those assigned male at birth age and causes the prostate to grow in size
Inflammation or infection of the prostate, like prostatitis or a urinary tract infection
Hormone medications, like testosterone
Ejaculation, which can raise the PSA level for a short period of time
Riding a bike, or anything that puts pressure on the area near the prostate
Trauma to an area near the prostate, for example from having a catheter placed
Inaccurate test results
Psa And Prostate Cancer: What Do My Numbers Mean
The prostateis a walnut-sized gland that sits below the bladder in men. It is responsible for creating semen, the milky liquid that carries sperm out of the body when a man ejaculates.
A PSA test is a blood test used to screen for prostate cancers. PSA is a protein produced in the prostate by both cancerous and noncancerous tissue. Elevated PSA levels can indicate the presence of cancer, but high PSA levels can also be a result of non-cancerous conditions like benign prostatic hyperplasia , or an infection. PSA levels also rise naturally as you age.
Elevated PSA levels do not necessarily mean that you have prostate cancer. PSA tests arent always accurate: many men who have prostate cancer have normal PSA levels. Alternatively, some men have high PSAs but dont have cancer. Or they have a slow growing form of cancer that would never have had symptoms or caused them any harm.
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Screening Tests For Prostate Cancer
Screening is testing to find cancer in people before they have symptoms. Its not clear, however, if the benefits of prostate cancer screening outweigh the risks for most men. Still, after discussing the pros and cons of screening with their doctors, some men might reasonably choose to be screened.
The screening tests discussed here are used to look for possible signs of prostate cancer. But these tests cant tell for sure if you have cancer. If the result of one of these tests is abnormal, you will probably need a prostate biopsy to know for sure if you have cancer.
How Psa Results Are Used For Diagnosis
In the past, many doctors wanted men with elevated PSA and/or an abnormal digital rectal examination to undergo a prostate biopsy. Today, this is not a course of action recommended by the American Urological Association. In such cases, multiparametric prostate MRI is now recommended as the best front-line test to detector rule outprostate cancer.
If a mpMRI shows a suspicious finding, a MRI-guided biopsy is the most accurate way to perform a biopsy of the prostate. If this is not possible, an MRI can be used with an ultrasound-guided biopsy. This is referred to as a fusion biopsy, and is more accurate than an ultrasound biopsy alone.
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Prostate Cancer Screening Ages 40 To 54
The PSA test is a blood test that measures how much of a particular protein is in your blood. Its been the standardfor prostate cancer screening for 30 years.
Your doctor will consider many factors before suggesting when to startprostate cancer screening. But hell probably start by recommending the PSAtest.
While the general guidelines recommend starting at age 55, you may need PSAscreening between the ages of 40 and 54 if you:
- Have at least one first-degree relative who has had prostate cancer
- Have at least two extended family members who have had prostate cancer
- Are African-American, an ethnicity that has a higher risk of developing more aggressive cancers
What Is Psa And How Do Psa Tests Work
The prostate is a small, apricot sized gland that sits below the bladder in males and uniquely produces prostate-specific antigen, a protein that circulates in the bloodstream. A PSA test is a blood test that measures prostate activity, reporting results as nanograms of PSA per milliliter of blood . Prostate cancer screening is generally recommended for men 55-70 years old or as young as 40 years old for men with a family or racial history that places them in a high-risk group. To benefit from prostate cancer screening, a man should be generally be healthy enough to have a 10-year life expectancy.
The range generally accepted as a normal PSA level spans from zero to four nanograms of PSA per milliliter of blood, though there are exceptions based on age, race, and risk factors. You and your physician can discuss whether any such nuanced situations apply to you. Keep in mind although a PSA test can certainly detect high levels of PSA in the blood, it is not enough to diagnose a cancer because an elevated PSA is not a definitive sign of prostate cancer.
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What Does It Mean
A normal PSA level is less than 3-4 ng/mL. Higher PSA levels mean the risk of prostate cancer is increased. Heres how your PSA relates to cancer risk:
Less than 3-4 ng/mL: The likelihood of prostate cancer is lower if your PSA level is less than 4 ng/mL. But this level doesnt completely rule out cancer. Around 1 in 7 people with normal PSA levels are discovered to have prostate cancer when more testing is done .
Between 3 and 10 ng/mL: This means the risk of prostate cancer is about 1 in 4.
Higher than 10 ng/mL: At this level, there is about a 50% chance that you have prostate cancer.
When interpreting your PSA level, its important to know if you have any other condition that could affect your PSA level. This way youll know whether you are at risk for having a low PSA level when cancer is present. Or a high level when there is no cancer.
My Psa Is Elevated What Could It Mean
First, realize that having an elevated PSA does not necessarily mean you have cancer in your prostate. Other causes for an elevated PSA include:
- infection, instrumentation of the urinary tract, disruption, trauma, or manipulation of the prostate
- certain conditions like prostatitis or enlarged prostate
You and your doctor will work together to identify any of these possible contributing factors to your higher PSA through measures like checking for urine infection, reviewing for history of instrumentation, inflammation and discussing family health history. You and your doctor may identify such a cause, address it with treatment, and re-test PSA to see whether the level has appropriately decreased.
If you and your doctor do not rule out any other causes, you will likely need to undergo another PSA test and a digital rectal exam. During this exam, a physician inserts a lubricated, gloved finger into the rectum to reach the prostate and feel for any lumps or hard areas. Continued abnormal results from the PSA test or rectal exam call for further investigation to identify clinically significant prostate cancer.
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What Are The Warning Signs Of Prostate Cancer
Some prostate cancer signs related to urination include:
- Burning or pain during urination.
- Difficulty urinating, or trouble starting and stopping while urinating.
- More frequent urges to urinate at night.
- Loss of bladder control.
7.Reduce or avoid foods that harm the prostate.
- Foods that contain acrylamide, such as French fries and potato chips and doughnuts.
- Sugars and sugary foods.
- Foods rich in saturated fats.
- Excess alcohol.
What Is Prostate Intraepithelial Neoplasia Or Atypical Or Suspicious Cells On Biopsy
In about 10% of prostate needle biopsy reports, the pathologist will tell us that the final diagnosis is neither benign nor malignant. They describe this condition as
- High Grade Intraepithelial Neoplasia
- A premalignant condition
- Biopsy should be repeated soon
- 25% risk of cancer on repeat biopsy
- Low Grade Intraepithelial Neoplasia
- Repeat biopsy is not indicated unless there is a rise in PSA
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Pros And Cons Of The Psa Test
- it may reassure you if the test result is normal
- it can find early signs of cancer, meaning you can get treated early
- PSA testing may reduce your risk of dying if you do have cancer
- it can miss cancer and provide false reassurance
- it may lead to unnecessary worry and medical tests when there’s no cancer
- it cannot tell the difference between slow-growing and fast-growing cancers
- it may make you worry by finding a slow-growing cancer that may never cause any problems
What Should I Expect If Im Told I Have Elevated Psa
If your provider finds an elevated PSA level, youll have repeat tests to check your prostate. Many men with elevated PSA levels even those who have prostate cancer live long, healthy lives. Prostate cancer may not need treatment, depending on how slowly the tumor is growing. Keep up with your regular appointments and tests so your care team can keep tabs on your health.
Diagnosis And Treatment Of Female Prostate Cancer
Due to the challenges of diagnosis, the signs of female prostate cancer are often mistakenly attributed to underlying conditions in the urinary tract or reproductive system.
Unfortunately, the initial stage of cancer in the Skene glands is asymptomatic. Once your menstrual cycle is disrupted, sex becomes painful, or youre always feeling sick, the disease is quite advanced.
Treatment of female prostate cancer follows a similar strategy to that of other reproductive cancers. If chemical and radiation therapies arent successful in eradicating tumors, then surgery will likely be required to excise them. Frequently, the surgical removal of larger tumors and the chemical destruction of smaller tumors happen simultaneously.
In more severe cases, the organ or organs containing the cancerous growths must be removed as well. This could include your Skene glands, uterus, ovaries, or your entire reproductive system . Whenever cancer in the Skene glands goes undiagnosed and untreated, bladder cancer may follow.
Medical experts have theorized that female prostate cancer could be linked to a history of sexually transmitted infections. The Skene glands, like the male prostate, act as guardians against infections that travel throughout the reproductive system.
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An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.
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What Does A High Psa Level Mean
High PSA levels could be a sign of prostate cancer or a different condition like prostatitis or an enlarged prostate.
Other things can affect your PSA level:
- Age. Your PSA will normally go up slowly as you get older, even if you have no prostate problems.
- Medications. Some drugs may affect blood PSA levels. Tell your doctor if youâre taking dutasteride or finasteride . These drugs may falsely lower PSA levels by half of what they should be.
If your PSA level is high, your doctor may suggest that you get a prostate biopsy to test for cancer.
Repeating The Psa Test
A mans blood PSA level can vary over time , so some doctors recommend repeating the test after a month or so if the initial PSA result is abnormal. This is most likely to be a reasonable option if the PSA level is on the lower end of the borderline range . For higher PSA levels, doctors are more likely to recommend getting other tests, or going straight to a prostate biopsy.
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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.
An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.