Have you ever heard of PSA? Sure! You probably know that it is something related to the prostate, some type of analysis that, along with the digital rectal examination, everyone should have at some time. But perhaps you don’t know when or why to do it or you feel a certain “fear” of taking the first step. Correct! PSA is related to the prostate, and we should all get tested at a certain age.
PSA (Prostate Specific Antigen) is a protein produced exclusively by prostate cells that can be detected in the blood of all men. Over the years, the prostate grows and the so-called benign prostatic hyperplasia (BPH) begins. With this benign growth, the PSA slowly rises.
In the event that there is prostate cancer, the PSA increases rapidly and reaches higher values. If this elevation is suspicious to your doctor, he or she will order a prostate biopsy. For better and best result in your PSA test make sure go to specialist such as Vie Aesthetics Harley Street.
When should you get a PSA?
The benefits of performing a PSA in all asymptomatic men for early detection of prostate cancer are controversial. Clinical trials have not shown a decrease in prostate cancer mortality from PSA testing. However, it has been seen that the number of patients diagnosed in advanced stages decreases, when there is no longer a curative treatment.
The European Association of Urology in its “Clinical guidelines on prostate cancer” recommends for the early diagnosis of prostate cancer an individualized strategy based on risk, to well-informed men with a good general condition and at least 10-15 years of experience. They also recommend a baseline PSA at age 40.
Can PSA be elevated without having prostate cancer?
The answer is yes. An elevated PSA above normal figures, in addition to being caused by prostate cancer, can also be due to other reasons: benign prostatic hyperplasia (BPH), prostatitis or other urinary infections, simply due to age, urological instrumentation (a catheter, cystoscopy, etc.) or perineal trauma.
In these circumstances your urologist will try to determine the cause of the PSA increase. A detailed clinical interview, urinalysis, ultrasound, flowmetry and digital rectal examination are the usual studies in the first instance. Based on them, the urologist will decide whether to repeat the PSA or directly perform a prostate biopsy.
Other situations that alter PSA are, for example, treatment with finasteride or dutasteride. Within 6 months of starting treatment, the PSA is halved. Therefore, to assess it, it must be multiplied by 2. The percentage of free/total PSA does not change and it is still considered normal above 20% (0.2).
What if you have an elevated PSA?
Your urologist may repeat your PSA if he thinks there may have been a transient elevation. If you have had an infection in your urine or semen, you will probably receive treatment and have your PSA repeated in 3 weeks. Why 3 weeks? Because transient PSA elevations require 3 weeks to resolve and PSA levels return to baseline.
If the PSA elevation is confirmed, then your urologist will order a prostate biopsy. Even in this case, you have to know that only a third of the prostate biopsies that are performed are positive for prostate cancer.
Now you have more information about the PSA. Remember that you should have an annual urological check-up from the age of 40 or 45 (better at 40 if you have a first-degree relative with prostate cancer).