PSA Test

The prostate-specific antigen test is a simple blood test used to evaluate the levels of the prostate-specific antigen (PSA) in a man’s blood

The prostate is a small, walnut-sized gland located just below the bladder in men. This gland helps contribute fluid to the semen, which helps sperm travel through the urethra and toward an unfertilized egg.

PSAs are protein cells that are produced by both cancerous and noncancerous tissue in the prostate. While PSAs are most prevalent in semen, small amounts of the protein cell circulate through the body via the bloodstream. Increased levels of PSA may indicate the presence of cancer cells in the prostate, or other conditions affecting the gland.

A PSA test helps determine the amount of prostate-specific antigen cells in your blood. An increased level of these cells may be linked to prostate cancer. However, PSA levels may also rise as a result of noncancerous prostate conditions such as:

- Benign prostate hyperplasia (BPH): BPH is an enlargement of the prostate. A man’s risk of developing BPH increases with age. BPH only causes symptoms in about half of diagnosed cases and does not lead to prostate cancer.

- Prostatitis: An infection of the prostate, prostatitis occurs when bacteria in urine leaks into the prostate. This can cause pain, flu symptoms, and difficulty with urination.

Because several benign conditions can cause a rise in PSA levels, these tests are rarely used to diagnose prostate cancer. If your doctor has ordered a PSA test, and the results show an increased level of PSA cells, you will usually be ordered to undergo a biopsy and transrectal ultrasound before you are diagnosed with prostate cancer.

In most cases, you will be ordered to refrain from sex or masturbation for 24 hours before your test. Releasing semen can cause PSA levels to rise, possibly leading to a false-positive test result.

Most blood tests are performed at a primary care office, often as a part of a routine check-up.

During your appointment, your arm will be wrapped in a band to push blood into the veins of the arm. This makes it easier to insert the needle that will be drawing blood from that area. You may feel a slight pinch as the needle is inserted into your arm, but this sensation should pass within a few seconds. The needle draws blood from a vein in your arm, depositing it into a vial or test tube. Some individuals or tests may require multiple tubes to be filled.

After the needed about of blood has been drawn, the needle will be taken out of your arm and the puncture site will be cleaned and bandaged. The blood will then be sent to a lab for testing and analysis.

You will get your results for most tests in 1-3 business days. Depending on the results of your blood test, your health care provider may request follow-up testing to provide a definitive diagnosis of any health conditions or diseases they may detect.

PSA tests are safe, generally painless, and quick procedures. They are not, however, a definitive diagnostic test for prostate cancer or prostate conditions. This is because PSA levels do not necessarily correspond with the presence of an infection. Certain medications - such as those used to treat BPH - lower PSA levels in the body. If you undergo a PSA test while taking this medication, the blood test may not be able to detect an infection due to medically lowered levels of the antigen protein.

The biggest risk of a PSA test is a misleading or overdiagnosis of prostate cancer. In some cases, PSA levels may be raised when no cancer is present. In others, the prostate cancer is so slow developing that it will never cause symptoms or death. The potential side effects of chemotherapy and radiation therapy used to combat prostate cancer may actually cause more damage to the body than these slow-progressing cancers.

Because of these factors, it is recommended that you undergo a second test - such as a biopsy or digital rectal exam (DRE) - before starting cancer treatment. Talk to your doctor about follow-up test procedures, and whether or not a prostate-specific antigen test is right for you.

The American Urological Association suggests the following guidelines regarding PSA testing.

Men with an average risk of prostate cancer are those who do not have a first-degree relative who has been diagnosed with prostate cancer. Higher risk populations include African-American men and men who do have a first-degree relative who has been diagnosed with prostate cancer.

The AUA’s suggestion is detailed below:

Under 40: Screening is not recommended

40-54 (Average risk): Screening is not recommended

40-54 (High risk): Talk to your doctor about whether or not PSA screening is right for you

55-69 (All): Yearly screening if recommended by your doctor.

Over 70: Screening is not recommended

The American Cancer Association recommends yearly screening based on these guidelines:

40-45: Recommended for those at high risk

50 and over: Recommended for those with average risk

Talk to your doctor about your risk factors, and whether or not regular PSA screening tests are right for you.

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