What Is It Used For
A PSA test is used to screen for prostate cancer. Screening is a test that looks for a disease, such as cancer, in its early stages, when itâs most treatable. Leading health organizations, such as the American Cancer Society and the Centers for Disease Control and Prevention , disagree on recommendations for using the PSA test for cancer screening. Reasons for disagreement include:
- Most types of prostate cancer grow very slowly. It can take decades before any symptoms show up.
- Treatment of slow-growing prostate cancer is often unnecessary. Many men with the disease live long, healthy lives without ever knowing they had cancer.
- Treatment can cause major side effects, including erectile dysfunction and urinary incontinence.
- Fast-growing prostate cancer is less common, but more serious and often life-threatening. Age, family history, and other factors can put you at higher risk. But the PSA test alone canât tell the difference between slow- and fast-growing prostate cancer.
To find out if PSA testing is right for you, talk to your health care provider.
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Getting A Prostate Biopsy
For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope. This test is the only way to know for sure if a man has prostate cancer. If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly.
For more details on the prostate biopsy and how it is done, see Tests to Diagnose and Stage Prostate Cancer.
For more information about the possible results of a prostate biopsy, see the Prostate Pathology section of our website.
What Does An Elevated Psa Level Mean If Ive Had Prostate Cancer In The Past
If youve ever had treatment for prostate cancer, youll have regular PSA screenings for the rest of your life. An increasing PSA level may mean the cancer has returned. Your care team may use other tests, including imaging scans and biopsies, to check for signs of cancer. If cancer returns, your team will discuss your treatment options with you.
How Common Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia is the most common prostate problem for men older than age 50. In 2010, as many as 14 million men in the United States had lower urinary tract symptoms suggestive of benign prostatic hyperplasia.1 Although benign prostatic hyperplasia rarely causes symptoms before age 40, the occurrence and symptoms increase with age. Benign prostatic hyperplasia affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men older than 80.2
When Is Bph Treatment Necessary
The course of BPH in any individual is not predictable. Symptoms, as well as objective measurements of urethral obstruction, can remain stable for many years and may even improve over time for as many as one-third of men, according to some studies. In a study from the Mayo Clinic, urinary symptoms did not worsen over a 3.5-year period in 73% of men with mild BPH. A progressive decrease in the size and force of the urinary stream and the feeling of incomplete bladder emptying are the symptoms most correlated with the eventual need for treatment. Although nocturia is one of the most annoying BPH symptoms, it does not predict the need for future intervention.
If worsening urethral obstruction is left untreated, possible complications are a thickened, irritable bladder with reduced capacity for urine infected residual urine or bladder stones and a backup of pressure that damages the kidneys.
- Inadequate bladder emptying resulting in damage to the kidneys
- Complete inability to urinate after acute urinary retention
- Incontinence due to overfilling or increased sensitivity of the bladder
- Bladder stones
- Recurrent severe hematuria
- Symptoms that trouble the patient enough to diminish his quality of life
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Currently, the main options to address BPH are:
- Watchful waiting
Causes Of An Elevated Psa Level
Prostate cancer typically leads to an elevated PSA level. Given that early-stage prostate cancer is generally limited to asymptomatic malignant changes at the cellular level, men have no way of knowing that something is wrong. This is why prostate cancer screening in the form of PSA testing is the best method of early detection. Please refer to the PSA Table for help in interpreting your PSA scores.
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Back Pain From Cancer
Rarely, it may be the first manifestation of cancer, says a paper in the Journal of General Internal Medicine .
The study authors point out that out of 1,975 walk-in patients at a clinic, only 13 were found to have cancer as a cause of their back pain.
Certain findings correlate to this, but these findings certainly dont automatically mean cancer:
At least 50 years of age
Previous history of cancer
Pain lasting longer than a month
No improvement with conservative therapy
Whats scary is that the paper says that metastatic cancer, when causing back pain, may not always cause other symptoms.
When cancer causes back pain, its more frequently in the lower region. Thus, pain specifically in the middle back, from this disease, would be even rarer.
Quite simply, pain in the back, be it low, middle or upper, has MANY causes including inflammatory bowel disease, irritable bowel syndrome, gastroesophageal reflux disease , fibromyalgia, aortic disease, imminent heart attack, premenstrual syndrome, benign ovarian cysts and overdoing it in a yoga class.
Dr. Psallidas is the main author of many peer-reviewed publications and book chapters in pleural disease and lung cancer.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
Top image: Freepik.com/ shayne_ch13
- Other organs
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Should Men At Elevated Risk Be Screened More Aggressively
It might sound logical to screen high-risk men earlier or urge men to adopt a healthy lifestyle to lower their risk for prostate cancer, but these areas have not been studied sufficiently. Therefore, physician organizations recommend more research and individualizing decisions about whether to get screened. Meanwhile, some leading organizations have issued recommendations, including:
- The American Urological Association The AUA recommends individualizing decision-making for men younger than age 55 who are high risk because they are African-American or have a positive family history. rel=nofollow> 7)
- The U.S. Preventive Services Task Force The USPSTF largely agrees largely with AUAs position and its 2018 recommendations are based on AUAs evidence review.
- The American Cancer Society The ACS takes this a step further, urging discussion about screening begin earlier for African-American men and men with first-degree relatives who have had prostate cancer.
Mayo Clinic Q And A: Prostate Biopsies And Elevated Psa
DEAR MAYO CLINIC: I recently had a physical, which included a check of my PSA level. The doctor said my PSA level is elevated, as it has been in the past. I have undergone several biopsies that have not shown cancer. Do I need to continue with biopsies every year?
ANSWER: It may not be necessary for you to continue with annual prostate biopsies. But that depends in part on the overall level and rate of change of your prostate-specific antigen, or PSA, over time. Along with information about your PSA, your health care provider can use several other tools to determine if you need additional biopsies or if you can be monitored safely without further biopsies.
The PSA test measures the amount of prostate-specific antigen in your blood. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate a small gland that sits below a man’s bladder.
When PSA is found to be above normal levels, a prostate biopsy may be recommended to check for cancer. Biopsies involve using a needle to collect several tissue samples from the prostate gland. Then the samples are examined in a lab to see if they contain cancer.
Although the PSA test is used primarily to screen for prostate cancer, other medical conditions can cause PSA levels to rise, as well. One of the most common is benign prostatic hyperplasia, or BPH. Basically, this condition is enlargement of the prostate gland that doesn’t involve cancer. Benign prostatic hyperplasia is common as men get older.
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How Is Benign Prostatic Hyperplasia Treated
Treatment options for benign prostatic hyperplasia may include
- lifestyle changes
- minimally invasive procedures
A health care provider treats benign prostatic hyperplasia based on the severity of symptoms, how much the symptoms affect a mans daily life, and a mans preferences.
Men may not need treatment for a mildly enlarged prostate unless their symptoms are bothersome and affecting their quality of life. In these cases, instead of treatment, a urologist may recommend regular checkups. If benign prostatic hyperplasia symptoms become bothersome or present a health risk, a urologist most often recommends treatment.
What Is Transrectal Ultrasound
Transrectal ultrasound is the examination of prostate using a machine called ultrasound. We insert a finger like probe into the rectum to examine the prostate. Ultrasound creates a picture of prostate using high-frequency sound waves. These sound waves come out of the probe and are transmitted through body tissues. The sound waves then bounce off the tissue and return to the probe. These returning sound waves are called echoes and are translated and recorded into photographic images. Transrectal Ultrasonography provides excellent visualization of the prostate and abnormalities that may be present in the prostate. We can also easily guide the biopsy needle under ultrasound guidance into the prostate where cancer is suspected.
The ultrasound machines in our offices are capable of doing color doppler studies and three dimensional reconstruction of the gland. Usually there is increased blood flow within the cancerous lesion or adjacent to the lesion and color doppler helps us precisely guide the biopsy needle into the lesion for accurate biopsy.
Transrectal ultrasonography is also used to estimate the prostate volume accurately to calculate PSA density.
Transrectal ultrasonography also provides images sensitive enough to defect capsular involvement and extention of cancer into the seminal vesicles .
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Prostate Problems And Related Urinary Symptoms
Many men have problems with the prostate at some time in their lives. The prostate gland is part of the male reproductive system. Its located just below the bladder. The prostate surrounds the urethra . The main function of the prostate gland is to add fluid to the semen. When problems occur in the prostate, the bladder and urethra are often affected as well. The most common prostate problems are described below.
What Should You Know About Psa Levels
Under normal circumstances, the serum secretions of PSA should stay under 4 nanograms per milliliter . People who have prostate malignancy usually have high PSA levels, but low or normal PSA doesnt always mean that the person is cancer-free. A smaller number of men with prostate cancer have low or normal PSA levels. This suggests that PSA test by itself is not a confirmatory test but can help in identifying who might be at risk of developing the cancer or has developed the malignancy.
Usually PSA test is preceded or coupled by DRE , in which the examiner inserts the finger in patients rectum to check for the consistency or edges of prostate gland. At risk patients with abnormal findings on the DRE and high PSA levels are subjected to biopsy to ascertain the cause and confirm the diagnosis. It is imperative to mention that False-Positives are common.
High PSA Levels without Prostate Cancer:
Testing errors such as mishandling of sample, measuring inconsistency, lifestyle choices and overall physical health can alter with PSA levels. Following are some physiological causes of high PSA levels.
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The Relationship Between Constipation And The Prostate Is Kind Of Like The Old Chicken And Egg Conundrum
The egg: Constipation, aka the build-up of feces in the intestine , can put pressure on the bladder and the prostate, which can cause symptoms resembling those associated with an enlarged prostate. The chicken: an enlarged prostate can put pressure on the rectum and cause constipation. But wait, theres more
What Are The Warning Signs Of Prostate Cancer
Some prostate cancer signs related to urination include:
- Burning or pain during urination.
- Difficulty urinating, or trouble starting and stopping while urinating.
- More frequent urges to urinate at night.
- Loss of bladder control.
- Blood in urine
7.Reduce or avoid foods that harm the prostate.
- Foods that contain acrylamide, such as French fries and potato chips and doughnuts.
- Sugars and sugary foods.
- Foods rich in saturated fats.
- Excess alcohol.
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Avoid Having Sex Before A Psa Test To Avoid False Results
Dr. David Samadi
Youâve made youâre appointment with the urologist for your annual PSA test. Whether a man looks forward to this doctorâs visit or not, it is a necessary part of screening for any issues that may be affecting the prostate gland.
Thereâs just one thing to remember no sex for 48 hours before the test.
A PSA, or prostate specific antigen test, is a simple blood test that measures the amount of prostate specific antigen present in the blood.
PSA is a protein that men have in their blood which is released by the prostate gland. In healthy males, the amount of PSA men have in their blood is low generally less than 4.0 ng/mL.
However, when men age, their prostate can experience physiological or pathological changes which cause the PSA to rise.
The prostate is a walnut-sized gland located between the bladder and the penis. The prostate is just in front of the rectum. The urethra runs through the center of the prostate, from the bladder to the penis, letting urine flow out of the body.
However, the PSA test is far from foolproof. Values of the PSA test can vary depending on when the test is administered. A man can help get the most accurate score by following certain suggestions before he has the PSA test done.
The reason for refraining from sexual activity right before getting a PSA test is that semen released during sex can cause PSA levels to rise temporarily, which may influence or affect the test results.
Ejaculation Is A Potential Cause Of Mildly Elevated Psa
“Ejaculation can cause a mild elevation of your PSA level, and so can having a digital rectal exam,” says Milner. “These types of PSA elevations are usually not enough to make a significant difference unless your PSA is borderline. PSA should return to normal in two to three days.”
To avoid this type of elevation, doctors will usually draw blood for a person’s PSA level before doing a rectal exam. Ask your doctor if you should avoid ejaculation for a few days before a PSA test.
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Prostatitis: Inflamed Prostate Can Be A Vexing Health Problem
- By Patrick J. Skerrett, Former Executive Editor, Harvard Health
When it comes to prostate trouble, the lions share of attention goes to prostate cancer and an enlarged prostate. A third condition, prostatitis, flies under the radar even though it affects up to one in six men at some point in their lifetimes. It triggers more than two million visits to doctors and untold agony each year.
Prostatitis, which means inflammation of the prostate gland, is an equal opportunity disorder. Unlike prostate cancer and benign prostatic hyperplasia , which predominantly affect older men, prostatitis affects men of all ages.
Prostatitis refers to a loose assemblage of syndromes characterized by urinary problems such as burning or painful urination, the urgent need to urinate, trouble voiding, difficult or painful ejaculation, and pain in the area between the scrotum and rectum or lower back. Although it causes some of the same symptoms as BPH and can occur at the same time, prostatitis is a separate condition.
Some types of prostatitis are caused by bacterial infection. These cases are often accompanied by the classic symptoms of infection, such as fever, chills, and muscle pain along with urinary problems. As a result, they are relatively easy to diagnose and treat, and they usually respond well to antibiotics. Unfortunately, such straightforward forms of prostatitis are the minority.
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Diagnosis And Treatment Of Female Prostate Cancer
Due to the challenges of diagnosis, the signs of female prostate cancer are often mistakenly attributed to underlying conditions in the urinary tract or reproductive system.
Unfortunately, the initial stage of cancer in the Skene glands is asymptomatic. Once your menstrual cycle is disrupted, sex becomes painful, or youre always feeling sick, the disease is quite advanced.
Treatment of female prostate cancer follows a similar strategy to that of other reproductive cancers. If chemical and radiation therapies arent successful in eradicating tumors, then surgery will likely be required to excise them. Frequently, the surgical removal of larger tumors and the chemical destruction of smaller tumors happen simultaneously.
In more severe cases, the organ or organs containing the cancerous growths must be removed as well. This could include your Skene glands, uterus, ovaries, or your entire reproductive system . Whenever cancer in the Skene glands goes undiagnosed and untreated, bladder cancer may follow.
Medical experts have theorized that female prostate cancer could be linked to a history of sexually transmitted infections. The Skene glands, like the male prostate, act as guardians against infections that travel throughout the reproductive system.
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