PSA Testing and Counselling

Many people have heard about the “prostate blood test”, and are confused about it’s true place in diagnosing prostate cancer.

Prostate specific antigen (PSA) is a protein produced by the prostate gland in men. PSA is in the semen to help keep the semen in its liquid form, but it can also be detected in the blood.

Normally, the PSA level in the blood increase as a man's prostate enlarges with age, but also sexual activity (ejaculation), inflammation of the prostate gland (prostatitis), or prostate cancer, can cause the PSA level in the blood to go up.

Clearly prostate cancer is not the only cause of a raised PSA, so sensible decisions need to be made about the result of the test.

Usually early prostate cancer does not cause any obvious symptoms, so the PSA test may help in early detection of prostate cancer.

The PSA level in blood is measured through a blood test, known as a PSA test, that utilizes a monoclonal antibody technique.

Additional blood tests, such as the ratio of “free” PSA to “bound” PSA, the rate of change of the PSA, and PSA levels at certain ages, in addition to new blood tests like Prostatic Health Index (PHI), can be used, along with the standard PSA, to allocate a patient into a “risk category”. Typically a digital rectal examination (DRE) of the prostate will be used to help to define that “risk category” for an individual patient, that is the chance of them having prostate cancer at that particular time.

A family history of prostate cancer can also be significant in determining an individual’s risk.

Once we know the risk, a sensible decision can be made about further investigation, which may include transrectal ultrasonography (TRUS) plus a biopsy done either via the rectal wall or, more commonly these days via the skin of the perineum between the scrotum and anus.

Increasingly Dr. Love is recommending multi-parameter MRI scans of the prostate to give even more information.

In addition to helping to provide early diagnosis, PSA levels may also helps to choose the right treatment option, when a cancer is diagnosed

The PSA test is also used to evaluate effectiveness of treatment procedures and to monitor improvement in the patient's condition.

In some unusual cases, patients may have prostate cancer with a normal PSA level in the blood. Therefore, the best way to monitor for early detection of prostate cancer is to have both the PSA test and digital rectal examination (DRE) performed.