PSA (Prostate Specific Antigen) Total
Understanding PSA (Prostate Specific Antigen) Total
What is PSA (Prostate Specific Antigen) Total?
A PSA (Prostate Specific Antigen) Total test measures the level of PSA, a protein produced by the prostate gland that liquefies the semen in males. This test helps identify conditions like prostate inflammation (prostatitis), enlarged prostate (benign prostatic hyperplasia or BPH), prostate cancer, etc.
The prostate is a small walnut-shaped gland located just below the bladder and in front of the rectum in males. It produces a protein called PSA, which is mostly found in semen (also produced by the prostate gland) and helps in sperm motility during ejaculation in males.
A PSA (Prostate Specific Antigen) Total helps determine the level of PSA, which if higher than normal, may be indicative of an enlarged (benign prostatic hyperplasia or BPH) or inflamed prostate (prostatitis), urinary tract infection, irritation, or other problems like urethral or prostatic trauma. The possible risk factors for high PSA levels include aging, prior family history, or a high-fat diet.
This test also serves as a useful tool to detect and monitor the progression of prostate cancer because PSA levels increase in the blood in the case of prostate cancer, the second most common type of solid cancer in men. PSA values regardless of levels should not be interpreted as absolute evidence of the presence or absence of disease. All values should be correlated with clinical findings and results of other investigations such as DRE. Additionally, a prostatic biopsy is required for the diagnosis of cancer. Prostate cancer does not show any symptoms in its early stages but may be fatal as it progresses to its advanced stages. Therefore, prostate health screening is important, particularly for those at higher risk. This test can also be used to check for cancer recurrence in those who have completed prostate cancer treatment.
Furthermore, low PSA concentrations are not always indicative of the absence of cancer. Some early cases of prostate cancer will not be detected by PSA testing or even DRE. Surgical castration or medical castration (with LHRH-agonist or antiandrogen therapy) can lower PSA levels dramatically. Therefore, a low PSA level after any treatment that includes hormonal therapy may not adequately reflect the presence of residual or recurrent disease.
You can eat and drink as per your daily routine before undergoing a PSA (Prostate Specific Antigen) Total test. However, ask your doctor about the required preparation before this test. Let them know about all the medicines you take as certain medicines may alter your test results. It is advised to avoid sexual intercourse for at least 48 hours before your test, as semen release can increase your PSA levels leading to inaccurate results. PSA test should not be done immediately after cystoscopy, digital rectal examination (DRE), ejaculation, prostatic massage, indwelling catheterization, ultrasonography, and needle biopsy of the prostate as they falsely elevate levels.
Test result ranges are approximate and may differ slightly between different labs depending on the methodology and laboratory guidelines. Values obtained with different assay methodologies should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. Talk to your doctor about your specific test results. Narrate your complete medical history to help them correlate your clinical and laboratory findings and formulate your treatment plan.
What is PSA (Prostate Specific Antigen) Total used for?
A PSA (Prostate Specific Antigen) Total test is done:
- If you have symptoms of any prostate condition such as painful or frequent urination, interrupted urine, blood in urine or semen, pelvic and/or back pain, or painful ejaculation.
- To detect and diagnose diseases of the prostate gland, like benign prostatic hyperplasia (BPH) or prostatitis.
- To screen for prostate cancer when used in conjunction with digital rectal exam (DRE), in men 50 years or older or to determine its extent. Testing should begin at a younger age in high-risk men (African-Americans) or those with first-degree relatives diagnosed at a younger age.
- To monitor prostate cancer treatment.
What does PSA (Prostate Specific Antigen) Total measure?
A PSA (Prostate Specific Antigen) Total test measures the level of prostate-specific antigen (PSA) in the blood. PSA is a protein secreted by the prostate gland in males and is found in two forms: bound PSA (bound to other proteins) and free PSA. A PSA (Prostate Specific Antigen) Total test measures both free and bound PSA levels. Most of the PSA produced in the body passes in the seminal fluid and only a small amount is secreted into the blood.
PSA levels in the blood get elevated in conditions affecting prostate health, like prostate cancer, prostatitis, and prostate enlargement (benign prostatic enlargement or BPH). This test is used as a primary screening test along with DRE, before conducting other diagnostic procedures.
Interpreting PSA (Prostate Specific Antigen) Total results
Interpretations
The normal value of PSA in blood is below 4.0 ng/ml
A roughly 4.0 and 10.0 ng/ml PSA level is considered a “grey zone.”
Lower than 4.0 ng/ml PSA in blood indicates a very low risk for prostate cancer or BPH, while higher than 10.0 ng/ml indicates a very high risk of developing prostate cancer or BPH.
Different forms of PSA testing, as well as other tests, are recommended for further diagnosis.