What Is The Psa Test For Prostate

Problems With The Psa Test

What Is A PSA Test (prostate-specic antigen)?

There are reasons doctors donât agree on whether you need this test:

Finding prostate cancer early doesnât always protect you. The PSA test often finds small, slow-growing tumors that arenât life-threatening. Treating them anyway, whether itâs with surgery or radiation, can expose you to harmful side effects and complications. Also, finding cancer early may not help if you have an aggressive tumor or if it spread to distant body parts before you found it.
The results arenât always accurate. If you have a high level but you donât have cancer, the test results can create a lot of worry and lead to medical procedures you donât need. A negative result if you really do have cancer can prevent you from getting treatment you do need.

What Do The Numbers Mean

PSA levels are measured as a number of nanograms in each milliliter of fluid tested. This is written as ng/mL.

PSA level 2.5 ng/mL or lower: This is a normal PSA level for men under age 60, but in some cases, prostate cancer may still be present.
PSA level between 2.5 and 4 ng/mL: This is a normal PSA level for most men.
PSA level between 4 and 10 ng/mL: This indicates that prostate cancer might be present. At this level, there is about a 25% chance that you have prostate cancer.
PSA level 10 ng/mL or above: There is a 50 percent chance that prostate cancer is present. The higher the PSA rises above 10 ng/mL, the greater the chance that you have prostate cancer.

Your doctor may also monitor your PSA velocity, or doubling time, which means recording your baseline PSA the level at your very first PSA test and seeing how fast the PSA level increases over time. Rapid increases in PSA readings can suggest cancer. If your PSA is slightly high, you and your doctor may decide to keep an eye on your levels on a regular basis to look for any change in the PSA velocity.

How Much Does The Test Cost

The price of a PSA test will vary based on where the test is conducted and whether you have health insurance. If you have health care coverage, you can reach out to your insurance provider directly to find out what a PSA test will cost under your plan. Depending on your plan, you may be responsible for out-of-pocket costs, such as copays and deductibles.

The cost of at-home PSA testing ranges from about $30 to $70.

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Does An Elevated Psa Mean I Have Cancer

About 3 out of 4 men with a raised PSA level will not have cancer.

A high PSA can be a sign of common prostate problems which are not related to cancer, such as prostatitis, or even a urine infection. Certain sports and medications may also temporarily affect PSA levels. You should avoid sexual activity for 48 hours before a PSA test. This is because ejaculation can temporarily increase your PSA levels.

If you decide to have a PSA test, your doctor will talk to you about what you should do before your test to help get an accurate result. It is important that you tell your doctor about any medications you are taking, including over the counter remedies and any kind of herbal or natural health supplements.

Why Do I Need A Psa Test

You may get a PSA test if you have certain risk factors for prostate cancer. These include:

A father or brother with prostate cancer
Being African-American. Prostate cancer is more common in African American men. The reason for this is unknown.
Your age. Prostate cancer is more common in men over the age of 50.

You may also get a PSA test if:

You have symptoms such as painful or frequent urination, and pelvic and/or back pain.
You’ve already been diagnosed with prostate cancer. The PSA test can help monitor the effects of your treatment.

Who Should Have Regular Screening Tests For High Psa

The PSA test was first developed to observe prostate changes in men who had a history of prostate cancer. Then it became more widely used in the general population as a way to detect and prevent prostate cancer before symptoms developed. But routine screening can find prostate cancers that grow slowly and do not need treatment. Talk to your healthcare provider to see if you should have regular PSA tests.

What Is The Prostate

The prostate is a walnut-shaped gland that is part of the male reproductive system. It has two or more lobes, or sections, enclosed by an outer layer of tissue. The prostate is located in front of the rectum and just below the bladder, where urine is stored. It surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen.

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Why The Test Is Performed

Reasons for a PSA test:

This test may be done to screen for prostate cancer.
It is also used to follow people after prostate cancer treatment to see if the cancer has come back.
If a provider feels the prostate gland is not normal during physical exam.

MORE ABOUT SCREENING FOR PROSTATE CANCER

Measuring the PSA level can increase the chance of finding prostate cancer when it is very early. But there is debate over the value of the PSA test for detecting prostate cancer. No single answer fits all men.

For some men 55 through 69 years old, screening may help reduce the chance of death from prostate cancer. However, for many men, screening and treatment could potentially be harmful instead of beneficial.

Before having the test, talk to your provider about the pros and cons of having a PSA test. Ask about:

Whether screening decreases your chance of dying from prostate cancer
Whether there is any harm from prostate cancer screening, such as side-effects from testing or overtreatment of cancer when discovered

Men younger than age 55 have a higher chance of developing prostate cancer and should talk with their provider about PSA screening if they:

Have a family history of prostate cancer
Are African American

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What Are The Symptoms Of Prostate Problems

What is a Normal PSA Test?

The symptoms of prostate problems may include

urinary retentionthe inability to empty the bladder completely
urinary frequencyurination eight or more times a day
urinary urgencythe inability to delay urination
urinary incontinencethe accidental loss of urine
nocturiafrequent urination at night
trouble beginning a urine stream
weak or interrupted urine stream
blockage of urine
urine that has an unusual color or odor
pain after ejaculation or during urination

Different prostate problems may have similar symptoms. For example, one man with prostatitis and another with BPH may both experience urinary urgency. Sometimes symptoms for the same prostate problem differ among individuals. For example, one man with BPH may have trouble beginning a urine stream, while another may experience nocturia. A man in the early stages of prostate cancer may have no symptoms at all. Because of this confusing array of symptoms, a thorough medical exam and testing are vital.

If I Have Elevated Psa Levels What Should I Ask My Healthcare Provider

If you have any symptoms of prostate cancer, or if it runs in your family, ask your provider:

Should I have regular tests to check my PSA level?
What can I do to lower my risk for prostate cancer?
What other tests or monitoring do I need?
What are my treatment options if I get prostate cancer?
What other signs or symptoms should I look out for?

A note from Cleveland Clinic

An elevated PSA level can be a sign of prostate cancer, but it doesnt always mean you have cancer. Your healthcare provider will watch you and do more tests to arrive at a diagnosis. Prostate cancer is often slow-growing and may never become life-threatening. If you have symptoms of prostate problems, such as difficulty urinating, don’t hesitate to let your provider know.

Last reviewed by a Cleveland Clinic medical professional on 04/06/2021.

References

What Does An Elevated Psa Level Mean If Ive Had Prostate Cancer In The Past

If youve ever had treatment for prostate cancer, youll have regular PSA screenings for the rest of your life. An increasing PSA level may mean the cancer has returned. Your care team may use other tests, including imaging scans and biopsies, to check for signs of cancer. If cancer returns, your team will discuss your treatment options with you.

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What Your Psa Numbers Mean

The PSA test measures the level of prostate-specific antigen in your blood. The lab will report your results in nanograms of PSA per milliliter of blood.

Only the prostate gland releases PSA, so your numbers should drop to almost zero within 4 weeks after your surgery. A test result above 0.2 ng/mL a few months after your procedure could be a sign that your prostate cancer has come back. This is called a biochemical recurrence.

If your number is higher than it should be, it doesn’t mean you definitely have cancer. Results can vary from person to person and from lab to lab. A more accurate way to find out if you have cancer is to test how quickly your PSA levels rise.

A PSA velocity test measures the change in your PSA levels over time. PSA doubling time tests calculate how long it takes for your PSA levels to double. If they rise quickly, it could be a sign of cancer. Knowing how fast yours is rising can help your doctor predict whether your cancer will spread, and if — or when — you’ll need treatment.

The Meaning Of Very Highly Elevated Psa

PSA 1000, is it possible, does it mean the mans death?First you have to confirm the lab result when it is above the normal limits.PSA levels 100+. Often show when Patients have advanced or metastatic prostate cancer.Very high PSA level usually mean strong indicator of multinodular prostate cancer and removal after biopsy.What is the PSA level to remove prostate?Prostate cancer removal depends on the pathological report of a biopsy taken from your prostate gland to decide the extension, shape, volume, and properties of the suspected cancerous cells, PSA are only used to monitor the progress of suspicious cells, then decide a biopsy procedure. However, highly elevated PSA total with low free PSA levels is a strong prostate cancer marker and a result required fast medical decision.Elevated High PSA after prostatectomy?A careful handling of PSA values after prostate removal is must,after prostatectomy you must wait for about six weeks to take a blood PSA test, because PSA levels are commonly show elevated after surgery, but its a false PSA result, however repeating the test after some weeks can declare if its just false or it may a cause of incomplete surgery or dangerous remnants of cancer cell.Now I think you understanding what does a high PSA test mean?Dont miss, What should my PSA level be in my previous interpretation about Normal PSA Levels

Psa Level Risk Analysis

15% of men with a PSA level less than 4 ng/ml go on to develop prostate cancer.
31% of men with PSA levels between 4 10 ng/ml have shown to develop prostate cancer.
50% 65% of men with psa scores over 10 ng/ml develop prostate cancer.

An important part of the your results is finding both the

1. Total amount of PSA in your blood.

2. Ratio of free vs bound PSA.

If Screening Test Results Arent Normal

If you are screened for prostate cancer and your initial blood PSA level is higher than normal, it doesnt always mean that you have prostate cancer. Many men with higher than normal PSA levels do not have cancer. Still, further testing will be needed to help find out what is going on. Your doctor may advise one of these options:

Waiting a while and having a second PSA test
Getting another type of test to get a better idea of if you might have cancer
Getting a prostate biopsy to find out if you have cancer

Its important to discuss your options, including their possible pros and cons, with your doctor to help you choose one you are comfortable with. Factors that might affect which option is best for you include:

Your age and overall health
The likelihood that you have prostate cancer
Your own comfort level with waiting or getting further tests

If your initial PSA test was ordered by your primary care provider, you may be referred to a urologist for this discussion or for further testing.

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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.

What Research Has Been Done To Study Prostate Cancer Screening

What is a PSA Test?

Several randomized clinical trials of prostate cancer screening have been carried out. One of the largest is the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which NCI conducted to determine whether certain screening tests can help reduce the numbers of deaths from several common cancers. In the prostate portion of the trial, the PSA test and DRE were evaluated for their ability to decrease a mans chances of dying from prostate cancer.

The PLCO investigators found that men who underwent annual prostate cancer screening had a higher incidence of prostate cancer than men in the control group but the same rate of deaths from the disease . Overall, the results suggest that many men were treated for prostate cancers that would not have been detected in their lifetime without screening. Consequently, these men were exposed unnecessarily to the potential harms of treatment.

A second large trial, the European Randomized Study of Screening for Prostate Cancer , compared prostate cancer deaths in men randomly assigned to PSA-based screening or no screening. As in the PLCO, men in ERSPC who were screened for prostate cancer had a higher incidence of the disease than control men. In contrast to the PLCO, however, men who were screened had a lower rate of death from prostate cancer .

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What Is A Prostate

A prostate-specific antigen test measures the level of PSA in your blood. The prostate is a small gland that is part of a man’s reproductive system. It is located below the bladder and makes a fluid that is part of semen. PSA is a substance made by the prostate. Men normally have low PSA levels in their blood. A high PSA level may be a sign of prostate cancer, the most common non-skin cancer affecting American men. But high PSA levels can also mean noncancerous prostate conditions, such as infection or benign prostatic hyperplasia, a noncancerous enlargement of the prostate.

Other names: total PSA, free PSA

New And Upcoming Tests For Prostate Cancer

The good news about new and upcoming tests for prostate cancer is that they can tell you more specific information than the PSA test alone.

You and your doctor can use the new urine test for prostate cancer to let you know if you have low-risk or high-risk prostate cancer, and this can help you make more-informed decisions about further testing and treatment. Also, a new genetic test that predicts prostate canceris on the way.

This, too, will allow doctors and patients to learn more about how aggressive their tumors are so they can make the right treatment decisions for them.

Talk to your doctor about your risk factors for prostate cancer. Knowing your risk factors along with your PSA level are some of the first steps in getting on track with your prostate health. Just be sure that you avoid doing any of the activities that can affect your PSA level for the 48 hours leading up to your test, and be aware of the other factors that can affect your PSA.

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Treating Increased Psa Levels

A PSA test is a biological marker or sign of an underlying condition. Physicians conduct further tests to determine the cause of the elevated PSA and treat the underlying condition. For example, if the increased PSA level is caused by prostate cancer, physicians treat the cancer.

Resources at Cedars-Sinai

Who Can Have The Psa Test

Although there is no screening programme, if you are aged over 50 you can ask your GP for the PSA test. Or you may be offered one as part of a general health check.

Before you have the test, your GP or nurse will talk through the benefits and disadvantages of having your PSA checked. If you are aged under 50 but at higher risk of prostate cancer, you can talk to your GP about having the PSA test.

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High Psa Levels From A Urinary Tract Infection

“Any infection near the prostate gland, including a urinary tract infection, can irritate and inflame prostate cells and cause PSA to go up,” says Milner.

If youve been diagnosed with a urinary tract infection, be sure to wait until after the infection has cleared up before you get a PSA test. In men, most urinary tract infections are caused by bacteria and respond well to antibiotics.

Having BPH increases your risk for a urinary tract infection.