A prostate-specific antigen (PSA) test is a screening test used to see if a man is at risk of having prostate cancer. It measures levels of PSA, a protein produced in the prostate, in the blood to determine if abnormal cell growth is occurring, and is usually recommended for men over 50 years of age during routine prostate screenings. In addition to the blood test, men may also be physically examined for signs of prostate enlargement or tenderness.
In the PSA cancer test, a blood sample is taken, usually from a vein in the elbow, and it is analyzed in the lab to determine the PSA levels in the patient's blood. As men age, the levels of PSA tend to go up. In men over 50, PSA levels higher than four nanograms per milliliter are a cause for concern, while in younger men, the cutoff is lower, around 2.3 nanograms per millilter. The time required to obtain results varies, and patients can ask their doctors how long they will have to wait.
If a PSA cancer test reveals elevated levels, it does not necessarily mean a man has cancer. Several other conditions can cause elevated levels including inflammation and infection around the prostate and urinary tract, benign prostate hyperplasia, and a history of recent catheterization or endoscopy. High test results are an indicator for more medical investigation to learn more about the man's health and find out why the PSA cancer test results were abnormally high.
After a PSA cancer test reveals high levels and a doctor confirms the presence of cancer, there are a number of treatment options available. Some patients may refuse treatment on the grounds that the cancer will grow slowly and the quality of life tradeoff with cancer treatment is not worth it to them. For patients who do want treatment, surgery, radiation, and hormone therapy are all potential options.
Screening for prostate cancer is not without controversy. Some critics point out the risk of false positives with options like the PSA cancer test and argue that prostate cancers tend to grow slowly and may not necessarily need treatment, leading men who receive early diagnoses to undergo unnecessary procedures. In men over 70, such testing is often discouraged because the patient is more likely to die of other age-related conditions than prostate cancer. Other people believe that early diagnosis and treatment should be promoted generally for cancers and support the use of prostate screening. Ultimately, patients should discuss the matter with their doctors, as every patient's situation is different.