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  • PSA Test

    A prostate-specific antigen (PSA) test measures the amount if prostate-specific antigen in a man’s blood. PSA is a protein found in prostate cells. All men have traceable amounts of PSA in their blood. Low levels of prostate-specific antigen in the blood are generally indicative of a healthy prostate. PSA levels are often elevated in the presence of certain prostate disorders, including prostate cancer. The following factors may influence PSA production:

    • Age
    • Injury
    • A Digital Rectal Exam
    • Sexual Activity (Ejaculation)
    • Inflammation of the Prostate (Prostatitis)
    • Prostate Cancer

    Why is a PSA Test Performed?

    Prostate-specific antigen testing is primarily used to monitor the progression of confirmed prostate cancers. Whether or not PSA testing can be used as a reliable screening / diagnostic tool is a matter of debate.

    • Treatment Observation: PSA testing is often used to monitor the effects of prostate cancer treatment. If PSA levels often decrease in the presence of a successful treatment strategy. Increased PSA levels, conversely, may indicate growing or spreading cancer. Men that have undergone prostatectomy usually have no traceable amounts of PSA in the blood.
    • Diagnosis: Since high PSA levels do not exclusively indicate prostate cancer, PSA testing is an extremely inaccurate diagnostic tool. However, PSA testing may be used in conjunction with other tests, such as biopsy or a digital rectal exam, to provide more comprehensive data about a patient’s prostate and overall health.

    How is a PSA Test Performed?

    A PSA test is simple, non-invasive, and does not necessitate recovery time. The test involves obtaining a blood sample for histological (microscopic) evaluation.

    • A healthcare professional will wrap an elastic band around your upper arm. This inhibits the flow of blood and causes your veind to bulge.
    • The needle site will be cleaned with antiseptic (germ-killing medicine).
    • A healthcare professional will gently insert a needle into a vein.
    • Blood will collect in an airtight vial or tube that is attached to the needle.
    • Once enough blood has been collected, the elastic band is removed from your arm.
    • Pressure will be applied to the needle site. Then, a bandage will be placed over the site to stop any bleeding and prevent infection.

    How Should You Prepare for a PSA Test?

    Getting ready for a PSA test is very simple. No major preparatory measures need to be followed. The patient should, however, avoid ejaculating during the two days prior to the test. Good communication with you doctor will ensure the best results. Discuss the following factors with your doctor:

    • Cystoscopy: Cystoscopic bladder exams may affect PSA levels.
    • Prostate Needle Biopsy: This procedure may affect PSA levels.
    • Infection: Certain infections, such as prostatitis and urinary tract infections (UTIs), may influence PSA levels.
    • Bladder Catheter: Bladder catheters (tubes) may affect PSA levels.

    PSA Test Side Effects

    Prostate-specific antigen testing is not associated with serious complications. However, the following side effects may occur:

    • Bruising: Bruising at the needle site is common. Bruises usually subside within days. The patient can minimize bruising by applying pressure to the needle site for several minutes following the PSA test.
    • Phlebitis: Rarely, a condition known as phlebitis (swelling of the vein) may occur after the PSA test.
    • Bleeding: For people with bleeding disorders, ongoing bleeding may be a problem after a PSA test. Blood-thinning medications, such as aspirin and warfarin (Coumadin), will amplify the effects of bleeding.

    Normal PSA Levels

    Normal prostate-specific antigen levels increase with age. As a result, age-specific ranges are often referenced. Some doctors, however, dispute the appropriateness of age-specific PSA ranges. These doctors insist that one range should be applied to all ages.

    Age Specific Prostate-Specific Antigen (PSA) Ranges

    • Men under 40 Less than 2.5 nanograms per milliliter (ng/mL)
    • Men age 40 to 50 0-2.5 ng/mL
    • Men age 51 to 60 0-3.5 ng/mL
    • Men age 61 to 70 0-4.5 ng/mL
    • Men over 70 0-6.5 ng/mL

    High PSA Levels

    Under most circumstances, prostate-specific antigen levels above 4 ng/mL are considered to be high. High PSA levels do not necessarily indicate prostate cancer.

    • From 4 to 10 ng/mL of PSA in the Blood: Approximately 20-30% of men with PSA levels in this range may have prostate cancer.
    • Above 10 ng/mL of PSA in the Blood: Approximately 40-60% of men with PSA levels in this range may have prostate cancer.

    References

    • The American Cancer Society, Inc. Retrieved on May 7, 2009 from .
    • WebMD, LLC. 2005-2009. Last updated May 15, 2007. Retrieved on May 7, 2009 from .
    • The National Cancer Institute. Retrieved on May 7, 2009 from .
    • Liou L. MD, Zieve D. MD for A.D.A.M., Inc. Retrieved on May 7, 2009 from.