What Is It Used For
A PSA test is used to screen for prostate cancer. Cancer screening means looking for signs of cancer before it causes symptoms. But screening tests can’t diagnose cancer. If a screening test finds signs of cancer, you’ll need other tests to find out if you have cancer and how serious it may be.
Most types of prostate cancer grow very slowly. They don’t spread beyond the prostate and may never cause health problems. In fact, you can live a long life with prostate cancer and never know you have it. The goal of prostate cancer screening is to help find cancers that may be more likely to spread so they can be treated early. But there are challenges and possible harms from using a PSA test to screen for prostate cancer:
- A PSA test can’t tell the different between abnormal PSA levels from prostate cancer and noncancerous conditions. If your PSA level is high, a prostate biopsy is the only way to find out if the cause is cancer. And prostate biopsies have possible harms.
- A PSA test may lead to finding and treating prostate cancer that would never have affected your health. If prostate cancer is found:
- It can be difficult to tell the difference between slow-growing cancers and those that are likely to grow faster and spread in your body.
- You could have prostate cancer treatment that you never really needed. And cancer treatment may cause serious harms, such as:
- Problems controlling your bowels
PSA testing may also be used to:
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.
Whats The Best Treatment For Prostate Symptoms
Treatments for prostate cancer include surgery to remove the prostate, radiation therapy, and ablation therapies, as well as active surveillance. Some treatments are better for some men and some prostates than others. There are side effects for each, so it really requires an informed discussion to help each man make an educated decision.
One thing we do at Yale is use an MRI of the prostate to evaluate the location of the prostate cancer for surgical planning. Ive found it to be quite helpful. Its not done everywhere.
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What Do My Psa Test Results Mean
Once your test results are back, your healthcare provider will let you know if any additional testing is recommended. PSA levels can vary over time for several reasons unrelated to prostate cancer . So, if you have a borderline PSA, your provider may simply recommend another PSA test in six months or so.
What Are Clinical Trials And Are They Right For You
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
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How Do I Prepare For A Prostate Ultrasound
You dont need to do much to prepare for a prostate ultrasound. Its an outpatient procedure that usually takes less than an hour. Your doctor may refer you to a hospital or clinic that has the proper ultrasound equipment for this test. You may also need to sign a consent form before the test.
Some possible instructions that your doctor might give you before the test include:
- Dont eat for a few hours before the test.
- Take a laxative or enema to help clear out your intestines a few hours before the test.
- Stop taking any medications that can thin your blood, such as nonsteroidal anti-inflammatory drugs or aspirin, about a week before the procedure. This is usually recommended if your doctor plans to take a biopsy of your prostate.
- Dont wear any jewelry or tight clothes to the clinic on the day of the procedure.
- Take any medications recommended to help you relax during the procedure. Your doctor may recommend a sedative, such as lorazepam .
- Make sure someones available to take you home in case your doctor gives you a sedative.
What Is Screening For Prostate Cancer
Some men get a PSA test to screen for prostate cancer. Talk to your doctor, learn what is involved, and decide if a PSA test is right for you.
Cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread.
There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.
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Using Medication To Reduce Symptoms
What Happens After A Prostate Exam
After the exam, the doctor can tell you straight away whether everything felt normal with your prostate. However, sometimes the prostate can feel fine even though there might be a problem. It can also have abnormalities caused by something other than cancer, such as inflammation or benign prostate enlargement.
This is why your prostate exam is often combined with a blood test called a PSA test. It looks for levels of a certain enzyme, which, if higher than normal, can be a sign of cancer.
It usually takes between 1-2 weeks to get the results back. Your prostate exam and PSA will determine whether any further tests are needed and help the doctor decide how regularly you need to be checked in the future.
If Your Gp Doesn’t Think You Need Any Tests Or A Referral
- Can you explain why I dont need to have tests or see a specialist?
- Is there anything I can do to help myself?
- Do I need to see you again?
- Who do I contact if my symptoms continue or get worse, especially during the night or at weekends?
- I’ve been reading about prostate cancer and wish to have a PSA test can you explain why I dont need one?
What Your Prostate Exam Results Mean
If the results of your prostate screening are not normal, your provider may want you to have more tests done, like a magnetic resonance imaging of your prostate. They might also want to do a prostate biopsy to look for signs of cancer.
If your prostate screening is normal, your provider can look at your PSA blood test results to figure out when you should have your next prostate cancer screening.
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Checking For Psa At Home
Itâs best to look for prostate symptoms and then screen using a Prostate Specific Antigen blood test. While there is no physical way for you to check for prostate cancer at home, there are at-home screening options for PSA. imawareâ¢ at-home test for PSA can help screen you for prostate issues.
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Medications For Enlarged Prostate
There are two main classes of pharmaceuticals that work to alleviate enlarged prostate symptoms: alpha blockers and alpha reductase inhibitors
Alpha Blockers. Alpha blockers relax the smooth muscle around the bladder neck and within the urethra.
Inhibitors. Inhibitors stop the conversion of the male hormone testosterone to DHT to reduce the prostates size, eliminating blockage.
Dont be surprised if your physician prescribes a combination of the two medications, as they have been shown to work more effectively together than alone. The downside is that combination therapy may increase the likelihood of experiencing side effects from the medications. Be sure to work with your doctor to assess the benefits and costs before starting on combination therapy.
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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.
The Test Is Often Not Needed
Most men with high PSAs dont have prostate cancer. Their high PSAs might be due to:
- An enlarged prostate gland.
- Recent sexual activity.
- A recent, long bike ride.
Up to 25% of men with high PSAs may have prostate cancer, depending on age and PSA level. But most of these cancers do not cause problems. It is common for older men to have some cancer cells in their prostate glands. These cancers are usually slow to grow. They are not likely to spread beyond the prostate. They usually dont cause symptoms, or death.
Studies show that routine PSA tests of 1,000 men ages 55 to 69 prevent one prostate cancer death. But the PSA also has risks.
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What Is A Prostate/rectal Ultrasound
A prostate or rectal ultrasound is an imaging test that uses sound waves tolook at your prostate or your rectum.
The healthcare provider uses a small probe called a transducer to make theimages of your prostate or rectum. The transducer is about the size of afinger. It is gently placed into your rectum, where it sends out soundwaves that bounce off your organs and other structures. The sound waves aretoo high-pitched for you to hear. The transducer then picks up the bouncedsound waves. These are made into pictures of your organs.
Your provider can add another device called a Doppler probe to thetransducer. This probe lets your provider hear the sound waves thetransducer sends out. He or she can hear how fast blood is flowing througha blood vessel and in which direction it is flowing. No sound or a faintsound may mean that you have a blockage in the flow.
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Psa Screening Blood Test
The American Cancer Society reports that men with a total PSA level of between 4 and 10 have roughly a 1 in 4 chance of having prostate cancer. With a total PSA of over 10, the chance of having prostate cancer rises to over 50%. Following the PSA test, if the levels are high, a doctor may suggest a repeat screening test or a prostate biopsy.
In addition to prostate cancer, there are many other factors that can affect a mans PSA levels.
Reasons for a High PSA:
- Enlarged prostate: An enlarged prostate can be caused by conditions like BPH, or benign prostatic hyperplasia, which is a non-cancerous enlargement of the prostate.
- Age: As men get older, its normal for PSA levels to slowly rise .
- Prostatitis: Infection or inflammation of the prostate gland, known as prostatitis, can also raise PSA levels.
- Bicycle Riding: Because the bicycle seat puts pressure on the prostate, some studies have shown that cycling may cause PSA levels to rise.
- Urologic procedures: Some urologic procedures can lead to higher PSA levels for a small period of time. Some studies have also shown that a digital rectal exam might also raise these levels.
- Medicines: Certain medicine, like testosterone or other medicines that raise testosterone levels, might cause a rise in PSA.
Reasons for a Low PSA:
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A Digital Rectal Exam
A digital rectal exam is a physical exam of your prostate gland administered by a physician in the context of a general checkup or in response to symptoms suggestive of an issue with the prostate gland. During a DRE, a physician places a gloved finger into the rectum and checks for asymmetric areas or nodules and irregularities in the size, shape and texture of the prostate gland, and it may also be used to look for signs suggestive of prostate cancer.
Like the PSA test, suspicious findings on a DRE do not necessarily mean that you have prostate cancer. Rather, the results are considered in combination with PSA test results and symptoms a patient may have.
Concerns have mounted recently about primary care doctors ability to use the DRE effectively. A recent study published in the Annals of Family Medicine found that only one-half of surveyed primary care doctors feel comfortable performing DREs. In fact, the authors of that study recommended against primary care doctors performing them.
Questions You Might Want To Ask Your Gp
- Do I need to see a specialist? Is it urgent?
- When will I see them?
- Where will I see them?
- Will I find out about my appointments by post or telephone?
- Do I need tests? What will they involve?
- How long should I expect to wait?
- Where can I find out more about tests?
- Do I have to do anything in preparation for this test?
- When will I get the results and who will tell me?
Your GP might not be able to answer all of your questions. They will tell you what they can at this point. Not knowing is difficult to cope with and can make you anxious.
Speaking to a friend or relative about how you feel might help.
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Who Should Get A Digital Rectal Exam
Not all medical institutions agree on when men should begin screening for prostate cancer or even if a DRE should be part of the screening.
To help detect prostate cancer in its early stages, the American Cancer Society recommends that men talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested.
For most men at average risk, discussions about screening begin at age 50. However, some doctors recommend that men at higher risk of prostate cancer â African-American men or men with a family history of prostate cancerâ start screening earlier.
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Seeing Your Gp When You Are Worried About Prostate Cancer
You might go to see your GP because you’re worried about prostate cancer. This might be because you know someone with it or have heard about prostate cancer or the PSA test in the news.
Or you might have some urinary symptoms, such as difficulty passing urine.
Whatever reason you have, don’t delay seeing your GP. It’s important to remember that most prostate cancers don’t cause symptoms and it is more likely that any symptoms you have are due to other causes. But if it is, the earlier it is picked up the higher the chance of successful treatment. You won’t be wasting your doctor’s time.
Try not to be embarrassed. What you tell your GP is confidential. Doctors are used to discussing intimate problems and will try to put you at ease.
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When To Get Your Prostate Checked: Warning Signs And Advice
A healthy prostate plays a vital role in male fertility, producing fluid that helps keep sperm alive. But as you get older, particularly after the age of 40, you may find that your prostate starts to cause you problems. One reason for this is that the prostate continues to grow as you age. This is a normal process but for many men, an enlarged prostate can cause symptoms that affect their quality of life. This isnt the only problem that affects the prostate, there are several other prostate issues, which can produce similar symptoms to each other. A prostate exam can help you find out whats going on with your prostate so your doctor can then help you get relief from any symptoms you may be experiencing.