Should I Have A Psa Test
If you have no symptoms of prostate cancer and are thinking about having a PSA test, you should ask your doctor about the risks and benefits.
While some studies suggest PSA reduces mortality on a population basis, the test picks up large numbers of cancers that would have caused no symptoms or harm in the patient. This is known as overdiagnosis. Overdiagnosis of prostate cancer can lead to unnecessary treatments that have side effects such as sexual impotence, urinary incontinence and bowel problems.
It is important to balance the potential benefit of detecting a prostate cancer early against the risk that detection and treatment may not be necessary. Treatment may affect your lifestyle but it may also save your life.
Make your own decision about whether to be tested after a discussion with your doctor. Ensure you get good quality information to make an informed decision.
Screening tests for breast, bowel and cervical cancer can save lives, but there is still confusion around PSA testing for prostate cancer. Find more information here.
Remember, if you have any concerns or questions, please contact your doctor.
When Should I Know The Results Of My Cancer Blood Tests
Many blood test results are ready within a day or two, but others take several days to a week.
Your healthcare provider will let you know when to expect your results and discuss them with you at an appointment.
A note from Cleveland Clinic
Blood tests can provide important information about your overall health, organ function and potential diseases. If youre having a blood test for cancer, ask your healthcare provider whats being tested and why. The results will be considered with several other factors, including symptoms and additional tests.
How Often Is A Prostate Exam Necessary
Your frequency of testing may be due to several factors, including your age, family history, and present health condition:
4049 Years of Age: Most urologists recommend men aged 40 and above to undergo a prostate exam if they have a family history or personal history of prostate cancer. Also, African-American men should talk to their doctor about how often to have these tests performed because they are at a heightened risk. The PSA test is the gold standard for prostate screening, and your doctor may also perform a digital rectal exam .
Your test results will further determine how often you may need a prostate exam. Generally, if your PSA result is under 2.5, you will likely only need the test every two years. On the other hand, if the result is higher, your doctor will probably recommend an annual prostate exam.
If the number is beginning to increase, your physician will probably ask you to return within a matter of months to have a follow-up test because an increasing PSA could indicate the presence of cancer cells. You may also need a biopsy.
50 Years and Above: Men with an average prostate cancer risk start getting a PSA exam at age 50. At this age, your provider may recommend an annual PSA and DRE. Your doctor will guide you regarding future PSA tests because the frequency may change as you age.
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How Much Does The Test Cost
The price of a PSA test will vary based on where the test is conducted and whether you have health insurance. If you have health care coverage, you can reach out to your insurance provider directly to find out what a PSA test will cost under your plan. Depending on your plan, you may be responsible for out-of-pocket costs, such as copays and deductibles.
The cost of at-home PSA testing ranges from about $30 to $70.
What Is The Phi Test
The PHI or Prostate Health Index test is a blood test that is used to predict the risk of having prostate cancer in men. The PHI test is used instead of the traditional PSA test. The Prostate Health Index test is actually derived from the PSA test. The PHI test is a combination of the free PSA, total PSA, and the proPSA isoform of free PSA. These 3 tests are mathematically combined in a formula that results in a Prostate Health Index or PHI score. The PHI score is a better predictor of prostate cancer than the total PSA test alone or the free PSA test alone. The Prostate Health Index is also a better predictor of prostate cancer risk than the free PSA to total PSA ratio or the free PSA ratio.
The PHI test offers better sensitivity as well as better sensitivity for prostate cancer. This means that men with a low score are less likely to have prostate cancer and those with a higher score are much more likely to have prostate cancer.
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Who Should Get Tested For Prostate Cancer
A blood test for prostate cancer is recommended for men aged 50 and above. Once youve hit your golden year, its time to get serious with an annual physical exam that includes a blood test to check prostate cancer.
Also, if you have a family history of prostate cancer or other cancers, for that matter, you opt to get tested for the condition as well. Consult your doctor if youre in doubt about the proper cancer screening tests.
Getting The Results Of The Biopsy
Your biopsy samples will be sent to a lab, where they will be looked at with a microscope to see if they contain cancer cells. Getting the results usually takes at least 1 to 3 days, but it can sometimes take longer. The results might be reported as:
- Positive for cancer: Cancer cells were seen in the biopsy samples.
- Negative for cancer: No cancer cells were seen in the biopsy samples.
- Suspicious: Something abnormal was seen, but it might not be cancer.
If the biopsy is negative
If the prostate biopsy results are negative , and the chance that you have prostate cancer isnt very high based on your PSA level and other tests, you might not need any more tests, other than repeat PSA tests sometime later.
But even if many samples are taken, biopsies can still sometimes miss a cancer if none of the biopsy needles pass through it. This is known as a false-negative result. If your doctor still strongly suspects you have prostate cancer , your doctor might suggest:
- Getting other lab tests to help get a better idea of whether or not you might have prostate cancer. Examples of such tests include the Prostate Health Index , 4Kscore test, PCA3 tests , and ConfirmMDx. These tests are discussed in Whats New in Prostate Cancer Research?
- Getting a repeat prostate biopsy. This might include getting additional samples of parts of the prostate not biopsied the first time, or using imaging tests such as MRI to look more closely for abnormal areas to target.
Prostate cancer grade
Gleason score
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How To Get A Psa Test
Consult with your general practitioner or urologist about receiving a PSA test in their offices. PSA tests are typically covered without co-pay or deductible by Medicare once a year for men 50 years and older. Many states now have laws which require private health insurers to cover the costs for PSA testing. However, additional PSA test costs may need to be covered by the patient. For those without insurance, or for those with insurance that does not cover PSA testing, free tools are available through advocacy groups, such as ZERO.
Companies such asimawaretm also offer in-home PSA testing kits and telemedicine appointments to discuss your PSA test results with a licensed physician. All imaware test kits are easy to use. After registering the test kit online, results will populate in the secure patient portal within 5-7 business days. You can submit your receipt of this test to insurance for potential reimbursement.
At-Home testing is now at a point where results can be provided accurately and quickly within 5 business days, with real physicians providing telemedicine support through the entire testing process
Dr. Diamandis Lunenfeld-Tanenbaum Research Institute, Sinai Health System
HALO Dx
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Psa Test For Prostate Cancer
The prostate gland makes a protein called prostate specific antigen . This protein helps to nourish sperm. Normally, only tiny amounts of it enter the bloodstream.
Cancer cells in the prostate interfere with proper functioning and can cause large amounts of PSA to enter the bloodstream. Therefore, when high levels of PSA are detected in the bloodstream, this may indicate cancer.
Early prostate cancer often has no symptoms. However, high PSA levels can occur five to 10 years before the onset of prostate cancer symptoms. In such circumstances, the PSA test can help to indicate the presence of cancer at an early stage.
Other tests are needed to confirm a diagnosis because an abnormal PSA test can be due to non-cancerous causes. Equally, it is possible for a man to have a normal PSA level when cancer is present.
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When Should I Get Tested
Visit Am I at Risk? to learn more. All men are at risk of prostate cancer, so it is important to talk with your doctor to make an informed decision. Check out our recommended age and testing guidelines, which are based on the NCCN provided recommendations.
Detecting prostate cancer early gives you the best chance of living longer. In fact, more than 99 percent of men survive prostate cancer when it is caught early.
Watch prostate cancer experts, Dr. Lowentritt and Dr. Siegel in this video discuss detection and diagnosis:
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What Is A Psa Test
The PSA test is the leading method of screening for prostate cancer. PSA screening can help catch the disease at an early stage when treatment may be more effective and potentially have fewer side effects. The PSA test may be done along with a digital rectal exam , in which a physician inserts a gloved finger into the rectum to examine the prostate for irregularities.
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Other Factors That Influence Psa Levels
The PSA blood test alone cannot diagnose prostate cancer. It is possible, although rare, to have prostate cancer without raised PSA levels in the blood. A higher-than-normal PSA level doesnt automatically indicate prostate cancer either. A high PSA level is due to cancer in around one in three cases.
PSA levels can be raised by other factors, including:
- , also known as benign prostatic enlargement .
For this reason, the PSA blood test isnt used in isolation when checking for prostate cancer.
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What Is A Normal Psa Test Result
There is no specific normal or abnormal level of PSA in the blood. In the past, PSA levels of 4.0 ng/mL and lower were considered normal. However, some individuals with PSA levels below 4.0 ng/mL have prostate cancer and many with higher PSA levels between 4 and 10 ng/mL do not have prostate cancer .
In addition, various factors can cause someones PSA level to fluctuate. For example, the PSA level tends to increase with age, prostate gland size, and inflammation or infection. A recent prostate biopsy will also increase the PSA level, as can or vigorous exercise in the 2 days before testing. Conversely, some drugsincluding finasteride and dutasteride, which are used to treat BPHlower the PSA level.
In general, however, the higher a mans PSA level, the more likely it is that he has prostate cancer.
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How Are Researchers Trying To Improve The Psa Test
Scientists are investigating ways to improve the PSA test to give doctors the ability to better distinguish cancerous from benign conditions and slow-growing cancers from fast-growing, potentially lethal cancers. And other potential biomarkers of prostate cancer are being investigated. None of these tests has been proven to decrease the risk of death from prostate cancer. Some of the methods being studied include
Selected References
Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. New England Journal of Medicine 2004 350:22392246.
Magnetic Resonance Imaging Scan
Result: An mpMRI shows if there is any cancer present in the prostate, whether it has spread to other parts of the body or is aggressive.
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What Are Some Common Prostate Problems
The most common prostate problem in men younger than age 50 is inflammation, called prostatitis. Prostate enlargement, or benign prostatic hyperplasia , is another common problem. Because the prostate continues to grow as a man ages, BPH is the most common prostate problem for men older than age 50. Older men are at risk for prostate cancer as well, but it is much less common than BPH.
Can Prostate Cancer Be Detected By A Blood Test
Prostate cancer develops in the prostate gland of men. It is one of the most common types of cancer. It is usually seen in men older than 50 years of age. The prostate is a small walnut-shaped gland that produces seminal fluid required to nourish and transports sperm. Prostate cancer develops slowly. More often, it is confined to the prostate gland, requiring minimal or no treatment.
It can take from 8 to 15 years for prostate cancer to spread from its origin to other parts of the body , typically the bones. In many cases, prostate cancer does not affect the man’s natural lifespan. Certain types of prostate cancer can be aggressive and spread quickly to other parts of the body. If prostate cancer is detected early and is confined to the prostate gland, the prognosis is excellent.
A prostate-specific antigen is often raised in cases of prostate cancers. This blood test is typically done as a screening test, routinely for older men to help detect the cancer in the early stages. It can also be done to monitor the progress of treatment in prostate cancers. However, it is not specific or accurate for cancer diagnosis. Infection of the prostate or the noncancerous enlargement of the prostate can also cause prostate cancer.
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Need For This Guidance
New Zealand men currently receive conflicting advice about prostate cancer testing and treatment. Some men may benefit from early diagnosis and treatment, but have limited opportunity to access appropriate health services.
Unlike other cancers, prostate cancer often grows slowly. With routine prostate specific antigen testing, many men can be diagnosed with a cancer that is not going to progress during their lifetime. Such a diagnosis may increase mens exposure to unnecessary treatment-related harms.
On the other hand, some men will still develop aggressive and potentially life-threatening prostate cancer. These men may benefit from prompt diagnosis and treatment.
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When To Startand Stopscreening
The doctors and researchers who recommend screening argue that cases of prostate cancer found very early can be cured more quickly, with less chance of relapse or spread. Those who recommend against routine screening point to the slow-moving nature of prostate cancer and the side effects of surgical and medical treatment, which can be considerable.
The introduction of PSA screening in the US led to an initial increase in the number of prostate cancer cases diagnosed each year, even though many of these new cases were non-aggressive or low-risk prostate cancer. The issue was not that screening was harmful, it was that many of these low-risk cancers did not necessarily need immediate treatment. It seems strange to say that a patient might be better off leaving cancer untreated, but in some cases, it can be true. For a few years, the United States Preventative Services Task Force recommended against PSA screening. We are now seeing more cases of advanced prostate cancer diagnosed in recent years. This may be a long-tail effect of that USPSTF recommendation. It has now been changed to note that for men aged 55 to 69 years, the decision to undergo PSA screening is an individual one and should be discussed with your doctor. USPSTF continues to recommend against screening for men aged 70 and over.
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What Is The Test To See If I Have Elevated Psa
Healthcare providers use a blood test to measure PSA levels.
You may have a digital rectal exam together with a PSA test to check for signs of prostate cancer. During a DRE, your provider inserts a gloved finger into the rectum to check for bumps or other irregularities.
Depending on the results of your initial test, your provider may want you to repeat the test. PSA levels can change. A second test gives your provider more details about your prostate health.
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Who Should Get A Psa Test
Not everyone should get a PSA test. Why? Because many in this country are treated for low-risk prostate cancer that is discovered through the PSA test, even when it is unlikely that the disease will ever cause symptoms or lead to death. And treatment is associated with significant side effects, including impotence and incontinence . You should discuss whether prostate cancer early detection is right for you with your personal primary care physician.
To avoid the risks of over-treatment, Roswell Park follows the guidelines established by the National Comprehensive Cancer Network . The NCCN brings together world-renowned experts from 30 of the nations top cancer centers to write guidelines that specify the best ways of preventing, detecting and treating cancer. The guidelines are updated at least every year, on the basis of the latest research.
Michael Kuettel, MD, PhD, MBA, Chair of Roswell Parkâs Department of Radiation Medicine, serves on the NCCN Prostate Cancer Panel.
If you decide that Prostate Cancer Early Detection is right for you, the NCCN recommends PSA testing as follows:
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