PSA Profile

A PSA Profile measures the levels of both free and total prostate-specific antigen (PSA) in blood and calculates the value of percent free PSA. It helps in the detection of prostate cancer and other prostate-related conditions such as prostate inflammation and enlarged prostate, and may even assist in differentiating between cancer and benign conditions. 

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 mostly 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. 

A PSA Profile helps determine the level of PSA (both free and total) in men. The total PSA level includes the amount of both free and bound PSA in the blood. Percent-free PSA is a ratio that compares the amount of free PSA to the total PSA level. A higher-than-normal total PSA level can indicate prostate conditions, including prostate cancer, the second most common type of solid cancer in men, prostatitis (inflammation of the prostate), and benign prostatic hyperplasia (BPH). This test also serves as a useful tool to monitor disease progression and assess response to treatment in prostate cancer patients and to check for recurrence in those who have completed prostate cancer treatment. Free PSA is useful in patients with moderately elevated PSA levels (4- 10 ng/ml) in whom a high percent free PSA suggests a benign cause while low percent free PSA values are more suspicious for prostate cancer. The doctor may advise a prostate biopsy based on the findings.

Your doctor may recommend a PSA Profile if you experience symptoms such as difficulty in 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 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 are taking 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 can increase your PSA levels leading to inaccurate results. PSA Profile 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.

PSA values regardless of levels should not be interpreted as absolute evidence of the presence or absence of disease. Elevated PSA levels alone do not confirm cancer, and further diagnostic tests, such as digital rectal examination (DRE) and biopsy, are needed to confirm or rule out the possibility of cancer. However, some early cases of prostate cancer will not be detected by PSA testing or even DRE. Furthermore, low PSA concentrations are not always indicative of the absence of cancer. 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.

Talk to your doctor about your specific test results. 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.