What is a PSA Test?
A man’s prostate produces a protein which is known as prostate-specific antigen. A simple blood draw from your arm can be analyzed for the nanograms of PSA per millimeter of blood. When there is a problem with the prostate, it can respond by releasing more and more PSA. The results will put you in one of three broad categories:

•    PSA under 4. This is considered normal, but about 15 percent of men in this range have prostate cancer.
•    PSA between 4 and 10. This level is intermediate. According to the American Cancer Society, this indicates a 25 percent chance of having prostate cancer.
•    PSA over 10. This level is usually considered high. Your prostate cancer risk is about 50 percent.

PSA Levels Can Go Up Due to Other Reasons
Several factors can falsely elevate your PSA level:

•    Non-cancerous enlargement of the prostate gland.
•    Ejaculation within two days of the PSA test.
•    Inflammation of the prostate gland.
•    Increased age. Many urologists now take into account the age of each patient, recognizing that a 40-year-old will not have the same PSA as an 80-year-old. Although there is no accepted agreement about the accuracy of specific PSA levels for different age groups, it’s generally accepted that an age-adjusted PSA rate of below 2.4 for men under 50, ranging to 6.5 for patients in their 70’s, is considered normal.

Medications Can Lower PSA Levels
It’s also possible that you can have a reading that has been lowered falsely. Tell your doctor about:

•    Any medications you may be taking.
•    Herbal supplements.

PSA Velocity More Important than PSA Level
Because PSA results can vary, it is widely considered that your PSA velocity, or whether or not your PSA reading goes up over time, is a better indicator of a problem than the results of one PSA test alone. A single test which is elevated may not be cause for alarm, but experts generally agree that three successively higher numbers over a period of 18 months warrant further testing.

Some healthcare professionals recommend that men get an initial test at age 40 and another at age 45 to get a baseline reading against which to compare later tests.

Is PSA Screening Meaningful?
Recent studies question the value of PSA testing, especially in men whose digital rectal exam was normal. Doctors at the New York Presbyterian Hospital of the Weill Medical College of Cornell University examined prostate biopsies performed at the hospital between 1993 and 2005.

The ratio of positive biopsies in men whose PSA level was between 2.0 and 3.99 was the same or higher than in men with levels of PSA that were 4.0 and more. The doctors could find no correlation between PSA level and positive biopsy findings. What does that mean for someone trying to decide whether or not to get a PSA exam?

Should I have a PSA Test?
The American Cancer Society recommends that men with at least a 10-year life expectancy be offered the test annually, starting at age 50. That limit is reduced to age 45 for high-risk individuals, such as African American men or those with at least one first-degree relative having been diagnosed with prostate cancer.

Some health professionals advocate regular PSA screening in the belief that finding the cancer early gives men more treatment options. Others think that the treatment side effects outweigh any benefit from early cancer treatment , when it is doubtful that the cancer would cause problems.

The American Cancer Society does not support routine PSA testing for prostate cancer at this time, nor do any other major scientific or medical organizations. Because prostate cancers are generally slow-growing, and because treatment side effects can seriously affect your quality of life, it is important to thoroughly discuss the pros and cons of PSA testing with your doctor. Whether or not to get tested is a personal decision.

Find out more about the prostate cancer treatment side effects.

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