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What is PSA?

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The prostate is a small gland located beneath the bladder that is a part of the male reproductive system. Its primary function is that it produces a fluid that mixes with sperm from the testicles to become semen. Prostate cancer is the most common cancer that occurs in men (Prostate Cancer UK, 2019). While prostate cancer can be a serious disease, many men who are diagnosed do not die from it, and live normally without treatment. This is why the choice to screen for prostate cancer is recommended by doctors to be a personal choice, rather than a part of governmental cancer screening programs, such as for breast cancer. 

What is PSA?

Prostate-specific antigen (PSA) is a protein produced by the prostate. A healthy prostate will only release small amounts of PSA into the bloodstream. However, older age, prostate conditions, and prostate cancer can cause prostate cells to produce more PSA, increasing the amount in the blood (Prostate Cancer Foundation, 2018). 

What is a PSA test?

A PSA test measures the amount of prostate-specific antigen in the blood. This test involves a blood sample that is sent to a laboratory for analysis. PSA is usually reported as nanograms per millilitre (ng/mL) of blood. PSA tests are often performed at a GP’s office or a blood collection clinic. Using new innovations in blood testing, it is now also possible to perform a PSA test from home. During a home test, the user collects their own blood sample and mails it to a laboratory for analysis. After the laboratory analyses the sample, the results are sent directly to the customer. Homed-IQ’s PSA Blood Test can be performed from the comfort of home at a time that suits you.

What are normal PSA levels?

Since PSA is affected by many different factors and changes over time, there is not one single normal PSA value. However, the following general guidelines apply (National Cancer Institute, 2022):

  • Generally, a PSA level of less than 4.0 ng/mL is considered normal. 
  • A PSA level between 4.0 and 10.0 ng/mL is considered to be the “borderline range” in which risk of prostate cancer is higher. 
  • A PSA level higher than 10.0 ng/mL indicates a greater than 50% chance of prostate cancer. 

It is important to note that some individuals may have a PSA lower than 4.0 ng/mL and have prostate cancer. Many others may have a PSA between 4.0 and 10.0 ng/mL and do not have prostate cancer. If your PSA is outside the normal range or if you are having prostate-related symptoms despite a normal PSA level, speak to your GP. Additional screening can be performed by your GP in the form of a prostate examination.

Does high PSA mean I have cancer?

No- as mentioned above, PSA can be affected by different factors and does not always indicate cancer. Aside from certain lifestyle and physical factors, prostate inflammation (prostatitis), urinary tract infections, and other infections of the genitourinary tract can cause elevated PSA. If your PSA test result is elevated, your GP will conduct additional tests to check for cancer. Be aware that the PSA test is not perfect and does not detect all cases of prostate cancer. 

What are the symptoms of high PSA levels?

High PSA levels can cause several prostate problems. If you are having any of the following symptoms despite a normal PSA level, speak to your GP:

  • Needing to urinate more frequently or feeling like you need to rush to the toilet
  • Weak urine flow
  • Blood in urine or semen
  • Difficulty in urinating
  • Feeling like your bladder has not emptied fully

Source: CDC, 2022

What can affect my PSA levels?

PSA levels can be elevated for many reasons. The most common reason is age, as older men’s PSA is naturally higher than that of younger men. Other factors that can affect PSA are:

  • Prostate size
  • Prostate conditions such as prostatitis
  • Stimulation of the prostate gland, such as from ejaculation or vigorous exercise (like bike-riding)
  • Certain medications, including finasteride

Source: Prostate Cancer Foundation

Who should take a PSA test?

The choice to do a PSA test is optional. Men who are between the ages of 50 and 74 with an average risk of prostate cancer may consider doing a PSA test. If prostate cancer runs in your family or you are considered to be at high risk, you may consider testing before age 50.  Before performing this test it is important to understand the risks and benefits. Please read “Risks and Benefits of Testing” before making the decision to perform this test. If you are unsure whether PSA testing would be appropriate for you, please contact your GP.

Testing for PSA is a personal choice. If you are interested in checking your PSA from the comfort of home, visit Homed-IQ’s PSA Blood Test to learn more. 

What happens if my PSA levels are abnormal?

If your PSA test is abnormal, inform your GP. You may have the option to undergo a digital rectal examination (DRE) to check for other signs of prostate abnormalities. You may also be referred to a urologist, where you can discuss the pros and cons of further testing and/or a prostate biopsy. Prostate cancer is often slow-growing and many men live the rest of their lives with prostate cancer without dying from it. This is why there is often no rush to treat the cancer, and some men may choose not to perform a biopsy due to the fear and anxiety associated with it. Furthermore, some men may find the harms of prostate cancer biopsy and treatment are higher than the benefits of diagnosing prostate cancer. The decision to proceed with a prostate biopsy will be up to you, and you should be well informed about the procedure before deciding to proceed. 

References

About prostate cancer. (n.d.). Prostate Cancer UK. Retrieved September 9, 2022, from https://prostatecanceruk.org/prostate-information/about-prostate-cancer#:%7E:text=Prostate%20cancer%20is%20the%20most,prostate%20cancer%20in%20their%20lifetime.

Prostate Cancer Foundation. (2018, January 28). What are Some Other Causes of a High PSA? Retrieved September 9, 2022, from https://www.pcf.org/blog/what-are-some-other-causes-of-a-high-psa/#:%7E:text=PSA%3A%20prostate%20specific%20antigen%20is,screening%20test%20for%20prostate%20cancer.

Prostate-Specific Antigen (PSA) Test. (2022, March 11). National Cancer Institute. Retrieved September 9, 2022, from https://www.cancer.gov/types/prostate/psa-fact-sheet#what-is-the-psa-test

Shah, P. J. A. S. M. D., MD. (2012, June 14). My PSA is elevated. Now What Should I Do? MD Anderson Cancer Center. Retrieved September 9, 2022, from https://www.mdanderson.org/cancerwise/my-psa-is-elevated-now-what-should-i-do.h00-158751534.html

What Are the Symptoms of Prostate Cancer? (2022, July 6). Centers for Disease Control and Prevention. Retrieved September 9, 2022, from https://www.cdc.gov/cancer/prostate/basic_info/symptoms.htm