Prostate Specific Antigens (PSA) tests are used in conjunction with DRE (digital rectal examinations) to evaluate your prostate for any abnormalities. The PSA result is age-specific. Consult your urologist for its correct interpretation.

Essentials of PSA

Your doctor often uses a PSA test to screen for prostate cancer. An elevated PSA by itself does not always mean that cancer is present. It simply alerts your doctor to evaluate your prostate.

There are other medical conditions that can cause your PSA level to increase. These conditions include an enlarged prostate (Benign Prostatic Hyperplasia, or BPH), and inflamed prostate (prostatitis), or a urinary tract infection.

A PSA test should always be combined with DRE to assess prostate health.
In the blood stream, PSA can be either free-floating or attached to other proteins. Men with cancer often have lower levels of free PSA than do those whose elevated PSa has other causes. Free PSA tests have been available for several years and can potentially be used to pinpoint patients who may be harboring cancer.

The introduction of total and free PSA has been extremely helpful. The lower the percent free PSA, the greater the likelihood of prostate cancer. Evaluating the free PSA level is extremely beneficial in men with serum PSA concentrations between 4 and 10 ng/mL, in that 29% of negative biopsies would be spared while retaining a 95% sensitivity.

Age-specific PSA

In younger men with PSA between 2 and 4 ng/mL, a much more aggressive appproach is taken in terms of getting an early biopsy. In older patients, 4 ng/MLis recoginized as cutoff.

PSA velocity

PSA velocity, which measures the rate of rise compared to the previous PSA level, is also taken as an indicator for further diagnostic testing.

If your PSA level is high what should be done next?

Your doctor may repeat the test or perform additional tests to see if there is any reason to suspect cancer of the prostate.