PSA Profile

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 prostate-specific antigen (PSA) that is mainly found in semen (also produced by the prostate gland) and is present in small amounts in the bloodstream of all men. It helps liquify the semen and facilitates sperm motility during ejaculation in males. 

The PSA Profile helps determine the level of total PSA, free PSA, and the value of percent free PSA in men. The total PSA level includes the combined amount of free and bound PSA in the blood. Free PSA determines the amount of PSA that is not bound to any proteins and circulates freely in the blood, while the Percent-free PSA is a ratio that compares the amount of free PSA to the total PSA level.

Your doctor may recommend the PSA Profile if you experience difficulty passing urine, straining or taking a long time while urinating, terminal dribbling, passing urine more frequently than usual, especially during the night, or blood in the urine. This test is also especially recommended in men over the age of 50 or at an earlier age (>40 years) for those at higher risk due to family history or other risk factors.

Fasting is not required for this test; you may eat and drink as per your daily routine. However, talk to your doctor if you take any prescription or over-the-counter medications, as some may interfere with your test results. It is advised to avoid sexual intercourse for at least 48 hours before the test, as semen release (ejaculation) can increase your PSA levels, leading to inaccurate results. The PSA Profile should also not be done immediately after cystoscopy, digital rectal examination (DRE), prostatic massage, indwelling catheterization, ultrasonography, and prostate needle biopsy as they too may falsely elevate PSA levels.

A higher-than-normal total PSA level may indicate prostate cancer, prostatitis (inflammation of the prostate), and benign prostatic hyperplasia (BPH). In patients with moderately elevated PSA levels (4- 10 ng/ml), a high percent free PSA suggests a benign cause, while low percent free PSA values are more indicative of prostate cancer. The PSA Profile also serves as a valuable tool to monitor disease progression, check for recurrence, and assess response to treatment in prostate cancer patients. Surgical castration or medical castration (using some drugs) can lower PSA levels dramatically. Therefore, a low PSA level after any such treatment that includes hormonal therapy may not adequately reflect the presence of residual or recurrent disease.

Talk to your doctor about your specific test results. Regardless of levels, PSA values are not absolute evidence of the presence or absence of disease. Further diagnostic tests, such as digital rectal examination (DRE) and biopsy, may be needed to confirm or rule out the possibility of cancer. However, some early cases of prostate cancer may not even be detected by PSA testing or DRE. 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 the course of therapy.