Prostate Specific Antigen Test
A blood test called a prostate specific antigen test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.
As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.
PSA levels also can be affected by
- Certain medical procedures.
Screening For Prostate Cancer
Prostate cancer is typically treatable if caught early. More than 90 percent of prostate cancers are found when the disease is in the beginning stages, confined to the prostate and nearby organs.
Unlike screenings for breast and colon cancers, there are no universal screening guidelines for prostate cancer. The U.S. Preventive Services Task Force recommends that men age 55 to 69 weigh the benefits and risks before deciding whether they should undergo screening, which is typically performed with a blood test that measures levels of a protein called prostate-specific antigen .
However, men in high-risk groupssuch as those who are of African-American descent and/or have a first-degree relative diagnosed with prostate cancer before age 65should consider speaking with their doctor about starting screenings at an earlier age.
Men older than 70 shouldnt be routinely screened for prostate cancer, according to the USPSTF.
Regardless of age or risk factors, men should get checked if they suddenly experience issues with urination, erectile dysfunction or unexplained pain.
The USPSTF suggests that, before deciding on a screening, men should seek expert advice about the benefits and harms of screening. Risks may include:
- False positives
- Complications and side effects from biopsies to confirm a diagnosis
- The possibility that a prostate cancer diagnosis wont extend lifespan or improve quality of life
How Is Bph Treated
In some cases, in particular where symptoms are mild, BPH requires no treatment. At the opposite extreme, some men require immediate intervention if they cannot urinate at all or if kidney/bladder damage has occurred. When treatment is necessary, many men will simply require daily medication. If this fails to completely treat the symptoms, or if there are signs of damage from BPH, the doctor may recommend minimally invasive endoscopic surgery . Or, in some cases, traditional surgery may be recommended.
- Drug treatment: The FDA has approved several drugs to relieve common symptoms associated with an enlarged prostate, including drugs that inhibit the production of the hormone DHT and drugs that relax the smooth muscle of the prostate and bladder neck to improve urine flow.
For surgery, there are many procedures to choose from, and the choice depends largely on your specific prostate anatomy, and surgeon preference and training. These procedures all have a common goal of widening the urethral channel as it passes through the prostate. Procedures include the following:
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- The prostate gland is a male reproductive organ that produces fluids to feed and protect sperm cells.
- Many men experience urinary changes as they age. In many cases, these changes do not need specific treatment.
- When urinary changes cause problems, they can be treated successfully by lifestyle changes, medication, surgery or a combination of the three.
- For problems such as blood in the urine, pain on urination, inability to urinate or uncontrollable urine flow, see your doctor promptly.
What Are The Complications Of Prostatitis
Men with acute bacterial prostatitis may develop sepsis. This widespread inflammation can be life-threatening. It requires immediate medical treatment.
Antibiotics can cause an upset stomach. Men with chronic bacterial prostatitis may need lots of antibiotics to treat recurring infections. Some people develop antibiotic resistance, making treatment ineffective.
Asymptomatic inflammatory prostatitis can lower sperm count, affecting fertility.
What Research Has Been Done To Study Prostate Cancer Screening
Several randomized clinical trials of prostate cancer screening have been carried out. One of the largest is the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which NCI conducted to determine whether certain screening tests can help reduce the numbers of deaths from several common cancers. In the prostate portion of the trial, the PSA test and DRE were evaluated for their ability to decrease a mans chances of dying from prostate cancer.
The PLCO investigators found that men who underwent annual prostate cancer screening had a higher incidence of prostate cancer than men in the control group but the same rate of deaths from the disease . Overall, the results suggest that many men were treated for prostate cancers that would not have been detected in their lifetime without screening. Consequently, these men were exposed unnecessarily to the potential harms of treatment.
A second large trial, the European Randomized Study of Screening for Prostate Cancer , compared prostate cancer deaths in men randomly assigned to PSA-based screening or no screening. As in the PLCO, men in ERSPC who were screened for prostate cancer had a higher incidence of the disease than control men. In contrast to the PLCO, however, men who were screened had a lower rate of death from prostate cancer .
Problems With Enlarged Prostate Gland
Benign enlargement of the prostate gland is more common as men get older. It can cause troublesome symptoms, although it doesnt always.
The urethra passes through the prostate gland, so men may have problems urinating if the enlarged gland restricts the flow of urine. If the flow stops completely, a catheter is required to empty the bladder. It is rare for this form of acute urinary retention to cause kidney damage.
An enlarged prostate doesn’t always cause urinary problems. Studies indicate that the size of a man’s prostate gland has little influence on the type or severity of his urination problems. BPH is just one possible cause of urinary symptoms.
Another cause of urinary symptoms can be changes to the muscular wall of the bladder, which may cause spasms of the bladder or weaken the bladder, causing problems passing urine.
When To Seek Medical Care For Prostate Infections
Contact a doctor for any of the following symptoms. These symptoms are even more significant if accompanied with high fever and chills:
- Urinary burning or pain
- Difficulty or pain when starting urination
- Pain in the genital area
- Pain with ejaculation
Doctors usually diagnose and treat prostate infections on an outpatient basis. If a person develops high fever with chills or a new onset of difficulty in urinating, seek medical care immediately or go to a hospital’s emergency department because the infection may be spreading to other areas of the body.
What Is The Prognosis For Prostatitis Does It Increase The Risk Of Developing Prostate Cancer
Prostatitis caused by bacterial illness often can be treated with antibiotics, or the condition can be chronic that recurs and requires long-term medical attention.
- Acute bacterial prostatitis can often be treated very successfully and has a very good prognosis.
- Chronic prostatitis, and especially chronic nonbacterial prostatitis, can often lead to long-term symptoms and discomfort if treatment is unsuccessful. It is important to have close follow-up and continued care by either your primary care doctor or a urologist.
- Prostatitis does not increase your risk of developing prostate cancer.
Pde5 Inhibitors: Viagra Levitra And Cialis
Approved by the FDA in 1998, sildenafil revolutionized the way we think about and treat erectile dysfunction, largely because it is so easy to use and effective. Since then the FDA has approved three closely related drugs, vardenafil , avanafil and tadalafil .
All four drugs work in a similar fashion, by affecting the normal physiology of the penis. In particular, they block PDE5, an enzyme that breaks down the erection-producing chemical cyclic guanosine monophosphate. This enables the penis to fill with blood and to stay erect long enough for intercourse. Of course, its important to realize that none of these drugs is an aphrodisiac. Youve got to feel sexually stimulated in order for them to work.
The main differences between the drugs have to do with timing: how quickly they begin to work, and how long their effects last . Levitra may start working slightly faster than Viagra although the FDA says that like Viagra, it should be taken about an hour before sexual activity. Some studies suggest that Levitra may help some men who dont respond to Viagra. And while some doctors are skeptical about this claim, theres no harm in trying Levitra or Cialis if Viagra doesnt work for you.
Cialis has also been approved to treat men with both erectile dysfunction and BPH. The dose is lower, usually 5 milligrams per day.
What Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia , or benign prostatic hypertrophy, is an enlargement of the prostate, a walnut-sized gland that forms part of the male reproductive system. During ejaculation, the prostate secretes fluid into the urethra, the narrow tube that runs through the center of the prostate. When a man urinates, the bladder squeezes urine out through the urethra.
As a man ages, the prostate can become enlarged. Because it surrounds the urethra right at the bladder exit, the prostate may squeeze or pinch the urethra as it gets larger over time. This may cause difficulty with urination such as a slow stream, the need to strain, increased frequency, urgency to urinate, incomplete emptying of the bladder, and intermittent flow or dribbling.
BPH is the most common disorder of the prostate gland and the most common diagnosis by urologists for males between the ages of 45 and 74. More than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.
Although research has yet to pinpoint a specific cause for BPH, theories focus on hormones and related substances like dihydrotestosterone , a testosterone derivative in the prostate that may encourage the growth of cells.
Part 2 Of 2:checking Your Prostate
How Are Prostate Problems Diagnosed
To diagnose prostate problems, the health care provider will perform a digital rectal exam . The health care provider will also ask the patient
- when the problem began and how often it occurs
- what symptoms are present
- whether he has a history of recurrent urinary tract infections
- what medications he takes, both prescription and those bought over the counter
- the amount of fluid he typically drinks each day
- whether he consumes caffeine and alcohol
- about his general medical history, including any major illnesses or surgeries
Answers to these questions will help the health care provider identify the problem or determine what medical tests are needed. Diagnosing BPH may require a series of medical exams and tests.
What Is Mri Of The Prostate
Magnetic resonance imaging is a noninvasive test used to diagnose medical conditions.
MRI uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of internal body structures. MRI does not use radiation .
Detailed MR images allow doctors to examine the body and detect disease. The images can be reviewed on a computer monitor. They may also be sent electronically, printed or copied to a CD, or uploaded to a digital cloud server.
Multiparametric is an advanced form of imaging. It uses three MRI techniques to provide anatomical pictures and information on the function of the prostate gland.
Mp-MRI assesses water molecule motion and blood flow within the prostate. This helps your doctor tell the difference between diseased and normal prostate tissue.
The prostate is part of the malereproductive system. It sits in front of the rectum, above the base of the penis, and below thebladder. The prostate surrounds the first part of theurethra. It helps make the milky fluid called semen. Semen carriessperm out of the body when a man ejaculates. Your doctor will most commonly use ultrasound or MRI to image the prostate.See the Prostate Ultrasound page for more information.
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.
Diagnosing Chronic Bacterial Prostatitis
Your doctor will also perform a digital rectal exam to examine the prostate. During this test, they will insert a lubricated and gloved finger into your rectum to look for signs of infection, such as a soft or enlarged prostate.
Your doctor may also use the following tests and techniques:
Antibiotics are the main course of treatment for this condition. Theyre usually taken for 4 to 12 weeks. For many people, treatment will last for 6 weeks.
First-line treatment is typically a fluoroquinolone antibiotic, such as ciprofloxacin , ofloxacin, or levofloxacin.
However, fluoroquinolones can increase your risk for a ruptured Achilles tendon, which is why they are no longer considered a preferred treatment.
Other commonly prescribed antibiotics include:
- sulfamethoxazole/trimethoprim , another first-line treatment
- tetracycline antibiotics, such as doxycycline or azithromycin
Tetracyclines are commonly used in cases where a doctor identifies or suspects chlamydia or mycoplasma genitalium. Like chlamydia, mycoplasma genitalium is an STI.
The antibiotic that youre prescribed will ultimately depend on which bacterium is causing your prostatitis.
Why The Test Is Performed
Reasons for a PSA test:
- This test may be done to screen for prostate cancer.
- It is also used to follow people after prostate cancer treatment to see if the cancer has come back.
- If a provider feels the prostate gland is not normal during physical exam.
MORE ABOUT SCREENING FOR PROSTATE CANCER
Measuring the PSA level can increase the chance of finding prostate cancer when it is very early. But there is debate over the value of the PSA test for detecting prostate cancer. No single answer fits all men.
For some men 55 through 69 years old, screening may help reduce the chance of death from prostate cancer. However, for many men, screening and treatment could potentially be harmful instead of beneficial.
Before having the test, talk to your provider about the pros and cons of having a PSA test. Ask about:
- Whether screening decreases your chance of dying from prostate cancer
- Whether there is any harm from prostate cancer screening, such as side-effects from testing or overtreatment of cancer when discovered
Men younger than age 55 have a higher chance of developing prostate cancer and should talk with their provider about PSA screening if they:
- Have a family history of prostate cancer
- Are African American
The PSA test result cannot diagnose prostate cancer. Only a prostate biopsy can diagnose this cancer.
A normal PSA level is considered to be 4.0 nanograms per milliliter of blood, but this varies by age:
What Clinical Trials Are Open
Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:Steven A. Kaplan, M.D., Weill Cornell Medical College; Michel A. Pontari, M.D., Temple University School of Medicine
How To Check Your Prostate
This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhirs expertise includes minimally-invasive treatments for enlarged prostate , kidney stone disease, surgical management of urological cancers, and mens health . His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article has 11 testimonials from our readers, earning it our reader-approved status. This article has been viewed 1,025,150 times.
What Natural Or Home Remedies Relieve Pain Symptoms And Treat Prostatitis
In addition to medical treatment, natural home remedies for prostatitis include:
- Warm sitz baths
- Avoid alcohol, caffeine, and spicy foods.
- Prostate massage: In a few studies, prostate massage has been shown to decrease symptoms in some patients with chronic nonbacterial prostatitis.
- Lifestyle changes: If you cycle or ride horses, it is recommended to suspend this activity until you improve.
- Although there are many herbal preparations available, there is no current evidence that herbal remedies are definitely helpful with prostatitis.
- Acupuncture has shown a decrease in symptoms for some people who suffer from prostatitis.
How To Prepare For The Test
Make sure your health care provider knows all the medicines you are taking. Some drugs cause your PSA level to be falsely low.
In most cases, no other special steps are needed to prepare for this test. You should not have a PSA test soon after having a urinary tract infection or undergoing a procedure or surgery involving the urinary system. Ask your provider how long you should wait.
Imaging Tests For Prostate Cancer
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. One or more imaging tests might be used:
- To look for cancer in the prostate
- To help the doctor see the prostate during certain procedures
- To look for spread of prostate cancer to other parts of the body
Which tests you might need will depend on the situation. For example, a prostate biopsy is typically done with transrectal ultrasound and/or MRI to help guide the biopsy. If you are found to have prostate cancer, you might need imaging tests of other parts of your body to look for possible cancer spread.
The imaging tests used most often to look for prostate cancer spread include:
How Are Bacterial Forms Of Prostatitis Managed Or Treated
Antibiotics can kill bacteria that cause bacterial types of prostatitis. Men with acute bacterial prostatitis may need 14 to 30 days of antibiotics, starting with IV antibiotics in the hospital. Rarely, men need surgery to drain an abscess on the prostate.
Treating chronic bacterial prostatitis is challenging. You may need up to three months of antibiotics to sterilize the prostate. If the prostate cant be sterilized, low-dose antibiotics can be used long term to prevent recurrences. Some men need surgery to remove prostate stones or scar tissue in the urethra. Rarely, surgeons remove part or all of the prostate gland .
Medication For Urinary Problems
Your doctor may suggest various medications to help ease your urinary problems, including:
- medications to reduce the tone of the muscles of the urethra and prostate to minimise any constriction to urine flow caused when these muscles contract
- medication to reduce the size of the prostate gland. These medications work by blocking the action of male hormones produced by the prostate gland
- medications to relax the bladder, making unwanted contractions less likely and reducing the symptoms of urgency and frequency of urination
- the over-the-counter preparation ‘saw palmetto’ is sometimes used. This may help some men, especially if frequent urination at night is a problem.
However, recent reviews of the evidence for using saw palmetto as a treatment for mild or moderate urinary symptoms did not show any improvement, compared to no treatment, in men with BPH.
How Does The Procedure Work
Unlike x-ray and computed tomography exams, MRI does not use radiation. Instead, radio waves re-align hydrogen atoms that naturally exist within the body. This does not cause any chemical changes in the tissues. As the hydrogen atoms return to their usual alignment, they emit different amounts of energy depending on the type of body tissue they are in. The scanner captures this energy and creates a picture using this information.
In most MRI units, the magnetic field is produced by passing an electric current through wire coils. Other coils are located in the machine and, in some cases, are placed around the part of the body being imaged. These coils send and receive radio waves, producing signals that are detected by the machine. The electric current does not come in contact with the patient.
A computer processes the signals and creates a series of images, each of which shows a thin slice of the body. These images can be studied from different angles by the radiologist.
MRI is able to tell the difference between diseased tissue and normal tissue better than x-ray, CT and ultrasound.
How Is The Procedure Performed
MRI exams may be done on an outpatient basis.
You will be positioned on the moveable exam table. Straps and bolsters may be used to help you stay still and maintain your position.
Devices that contain coils capable of sending and receiving radio waves may be placed around or next to the area of the body being scanned.
MRI exams generally include multiple runs , some of which may last several minutes.
Your exam may use an endorectal coil. If so, a nurse or doctor will place a disposable cover over the coil. They will lubricate the assembly and insert the coil a short distance into your rectum. After insertion, the doctor inflates the circular balloon that sits around the coil and holds it in place during the exam. When the exam is complete, the doctor deflates the balloon and removes the coil.
You will be placed into the magnet of the MRI unit. The technologist will perform the exam while working at a computer outside of the room.
If a contrast material is used during the exam, it will be injected into the intravenous line after an initial series of scans. More images will be taken during or following the injection.
When the exam is complete, you may be asked to wait while the radiologist checks the images in case more are needed.
Your IV line will be removed after the exam is over.