Prostate Specific Antigen (PSA)

Serum
Optimal Result: 0 - 4 ng/mL.

Prostate-specific antigen (PSA) is one of the proteins that the prostate gland makes. Cancerous cells of the prostate also create these proteins. The purpose of the PSA test is to identify that the prostate gland is stressed and may have significant disease. 

High PSA levels are not necessarily correlated with cancer. They may mean that there is a urinary tract infection or the prostate is simply inflamed.  According to the National Cancer Institute, “there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men in any racial or ethnic group.”

What is a normal PSA test result?

There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.

However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer.

In addition, various factors can cause a man’s PSA level to fluctuate. For example, a man’s PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugs—including finasteride and dutasteride, which are used to treat BPH—lower a man’s PSA level. PSA level may also vary somewhat across testing laboratories.

Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of white men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.

In general, however, the higher a man’s PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a man’s PSA level over time may also be a sign of prostate cancer.

Sources:

  1. http://www.lifeextension.com/magazine/2006/5/report_blood/Page-02
  2. https://www.cancer.gov/types/prostate/psa-fact-sheet
  3. https://www.mayoclinic.org/tests-procedures/psa-test/about/pac-20384731
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850026/

What does it mean if your Prostate Specific Antigen (PSA) result is too high?

Elevated levels of prostate-specific antigen (PSA) can indicate various prostate issues, including prostate cancer, benign prostatic hyperplasia (BPH), or prostatitis. PSA is a protein produced by both normal and malignant cells of the prostate gland, and its levels are measured through a blood test.

Significance of Elevated PSA Levels

→ Prostate Cancer: High PSA levels can be a sign of prostate cancer, but they are not definitive. Many factors, such as age, race, and prostate size, can influence PSA levels.

→ Benign Conditions: Elevated PSA can also indicate non-cancerous conditions like BPH or prostatitis, which do not lead to cancer but can coexist with it.

→ Other Influences: PSA levels can be temporarily elevated due to recent ejaculation, a prostate examination, or vigorous exercise.

Symptoms and Testing

Symptoms prompting a PSA test may include difficulty urinating, frequent urination, pain during urination or ejaculation, blood in urine or semen, and chronic pain in the lower back, hips, or thighs. However, these symptoms can also be related to non-cancerous conditions.If PSA levels are elevated, further testing is often recommended, such as repeat PSA tests, digital rectal exams (DRE), prostate biopsies, or imaging tests like MRI or CT scans.

Treatment Options

→ Prostate Cancer: Treatment may include active surveillance, surgery, radiation therapy, hormone therapy, chemotherapy, or a combination of these, depending on the cancer's stage and the patient's overall health.

→ BPH: Treatment might involve medication, lifestyle changes, or minimally invasive therapies.

→ Prostatitis: Often caused by a bacterial infection, it may be treated with antibiotics.

Consultation and Management

Individuals with elevated PSA levels should discuss their condition with healthcare providers to determine the best course of action based on individual risk factors, symptoms, and overall health. Specialists in urology or oncology can provide personalized advice and treatment plans.

Diet and Lifestyle

Some studies suggest that dietary changes, such as increasing lycopene intake, may help manage PSA levels. Lycopene, found in tomatoes and other red fruits, acts as an antioxidant and may offer some protective benefits. However, these dietary interventions should complement medical advice and treatment plans.

What does it mean if your Prostate Specific Antigen (PSA) result is too low?

Low levels of PSA are not a health problem. 

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