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Prostate Specific Antigen (Total) PSA

For men

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Prostate Specific Antigen (PSA) is a protein secreted by the prostate gland. PSA total measures the PSA levels (both free and bound) in blood. This protein is produced by normal as well as cancerous cells. PSA is considered to be a tumor marker since its levels in the blood are elevated in prostate cancer. It serves as a useful tool to monitor the progression of prostate cancer.
The most frequent conditions that cause an elevation in PSA level are prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH).

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What does Prostate Specific Antigen (Total) PSA measure?

The PSA Test measures the total PSA levels (both free and bound) in blood.

PSA is a protein which is secreted by the prostate gland. The prostate gland is a male accessory reproductive organ, the secretion of which contributes to the formation of the seminal fluid. Most of the PSA produced is secreted in the seminal fluid along with prostatic secretions and only a small amount is secreted into the bloodstream. PSA is considered to be a tumor marker since its levels in the blood are elevated in prostate cancer and BPH, and it is used as a preliminary screening test before further diagnostic procedures.

PSA in blood is found as either complexed PSA (bound to other proteins) or free PSA. The PSA Test usually calculates the total PSA levels in blood including both free and complexed forms. Separate tests for the levels of these two forms can be used to distinguish between prostate cancer and BPH.

FAQs related to Prostate Specific Antigen (Total) PSA

Is there any preparation required before the PSA test?

You should not have produced semen during sex or masturbation (ejaculated) in the previous 48 hours or Exercised heavily in the previous 48 hours. You should not have undergone a prostate biopsy in the previous six weeks or had a rectal examination (a digital rectal examination) in the previous week.

What factors can affect the test results?

The PSA levels in the blood can be affected by a number of factors including: · Ejaculation · Direct prostate examinations · Physical activities like cycling, horse-riding, etc. · Chemotherapy · Infections of the prostate gland · Prostate Biopsy · Cystoscopy (a procedure where an endoscope is inserted through the urethra to examine the urinary bladder) · Urinary catheter · Urinary tract infections

What additional tests can be prescribed by your doctor in case the result of PSA test is not normal?

Additional tests that may be prescribed in case of abnormal PSA test result are: · Digital Rectal Examination (DRE) · Free PSA Test · Urinalysis · Prostate Ultrasound · Prostate Biopsy

What is BPH?

Benign Prostatic Hyperplasia or BPH is a condition characterized by enlargement of the prostate gland. Enlargement due to BPH is usually caused due to aging and does not develop into cancer. The enlarged prostate puts pressure on the urethra and leads to blockage, causing urinary retention, weak or no urine flow, urinary bladder stones, infections or kidney damage.

Can the PSA test detect all types of prostate cancer?

Increased PSA level is usually an indication of prostate cancer. However, it cannot confirm the diagnosis of cancer since elevated PSA levels can be seen in other conditions as well. Also, PSA levels are not significantly increased in slow growing forms of prostate cancer and many times prostate cancer can occur without increased PSA levels. PSA is usually accompanied by other tests like Digital Rectal Examination and biopsy to confirm the diagnosis of cancer.

Is there any risk associated with this test?

There is no risk associated with the test. However, since this test involves a needle prick to withdraw the blood sample, in very rare cases, a patient may experience increased bleeding, hematoma formation (blood collection under the skin), bruising or infection at the site of needle prick.

In what other ways are the PSA test results evaluated to help in diagnosis?

PSA Test results can also be evaluated in the following ways: · PSA Velocity: Estimates increase or decrease in PSA levels over time. A significant increase indicates cancer. Faster the increase in PSA, more aggressive is the cancer. · PSA Doubling Time: Also tracks PSA increase by measuring the time in which PSA levels double. · PSA Density: Measures PSA levels in blood against volume of the prostate gland seen by ultrasound. The PSA levels should be in accordance with the visible volume of prostate, higher levels indicate chance of cancer. · Age-specific PSA: PSA levels increase with age, hence the normal range of PSA is to be established for the age of the particular person being tested.

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