There Are Risks To Getting Prostate Cancer Tests And Treatments
If your PSA is not normal, you will probably have a biopsy. The doctor puts a needle through the wall of the rectum and into the prostate to take a few samples. Biopsies can be painful and cause bleeding. Men can get serious infections from biopsies, and they may need hospital care.
Surgery or radiation are the usual treatments for prostate cancer. They can do more harm than good. Treatment can cause serious complications, such as heart attacks, blood clots in the legs or lungs, or even death. In addition, 40 men out of 1,000 will become impotent or incontinent from treatment.
When Is A Psa Test Needed
If you are age 50 to 74, you should discuss the PSA test with your doctor. Ask about the possible risks and benefits.
Men under 50 or over 75 rarely need a PSA test, unless they have a high risk for prostate cancer.
- You are more likely to get prostate cancer if you have a family history of prostate cancer, especially in a close relative such as a parent or sibling.
- Your risks are higher if your relative got prostate cancer before age 60 or died from it before age 75. These early cancers are more likely to grow faster.
- If you have these risks, you may want to ask your doctor about getting the PSA test before age 50.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
Repeating The Psa Test
A mans blood PSA level can vary over time , so some doctors recommend repeating the test after a month or so if the initial PSA result is abnormal. This is most likely to be a reasonable option if the PSA level is on the lower end of the borderline range . For higher PSA levels, doctors are more likely to recommend getting other tests, or going straight to a prostate biopsy.
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Normal Psa Levels By Age Chart
We mentioned earlier in this article that PSA levels increase with age due to age related growth of the prostate gland. A doctor will therefore take into account an age-adjusted PSA level when discussing your prostate health:
0 to 6.5
Although there are normal PSA levels by age range, it is still important to screen routinely to ensure these normal levels are not rising.
Why Do I Need A Psa Test
You may get a PSA test if you have certain risk factors for prostate cancer. These include:
- A father or brother with prostate cancer
- Being African-American. Prostate cancer is more common in African American men. The reason for this is unknown.
- Your age. Prostate cancer is more common in men over the age of 50.
You may also get a PSA test if:
- You have symptoms such as painful or frequent urination, and pelvic and/or back pain.
- You’ve already been diagnosed with prostate cancer. The PSA test can help monitor the effects of your treatment.
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What Are Normal Psa Levels
Thereâs no such thing as a normal PSA for any man at any given age, but most men with prostate cancer have a higher than normal level. In general:
If your PSA results are in the borderline range , the % free PSA can be useful in helping distinguish between prostate cancer or benign prostatic hyperplasia . The pattern is the opposite of that seen with PSA in that a high % free PSAâabove 20%âpoints to BPH, while a %- free PSA less than 10% indicates a greater likelihood of cancer.
Why Is A Prostate
A PSA blood test is performed to detect or rule out prostate cancer. The amount of PSA in the blood is often higher in men who have prostate cancer. However, an elevated PSA level does not necessarily indicate prostate cancer. The U.S. Food and Drug Administration has approved the PSA blood test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret a PSA blood test, its ability to discriminate between cancer and problems such as BPH and prostatitis, and the best course of action if the PSA level is high.
When done in addition to a DRE, a PSA blood test enhances detection of prostate cancer. However, the test is known to have relatively high false-positive rates. A PSA blood test also may identify a greater number of medically insignificant lumps or growths, called tumors, in the prostate. Health care providers and patients should weigh the benefits of PSA blood testing against the risks of follow-up diagnostic tests. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection.
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Adverse Reactionsadvanced Gbrcam Ovarian Cancer
Most common adverse reactions in 20% of patients in clinical trials of LYNPARZA for advanced gBRCAm ovarian cancer after 3 or more lines of chemotherapy were: fatigue/asthenia , nausea , vomiting , anemia , diarrhea , nasopharyngitis/upper respiratory tract infection , dyspepsia , myalgia , decreased appetite , and arthralgia/musculoskeletal pain .
Most common laboratory abnormalities in 25% of patients in clinical trials of LYNPARZA for advanced gBRCAm ovarian cancer were: decrease in hemoglobin , mean corpuscular volume elevation , decrease in lymphocytes , increase in serum creatinine , decrease in platelets , and decrease in absolute neutrophil count .
Deciding If You Need A Prostate Screening
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Factors That Affect Psa Levels
It is important to note that PSA levels can rise naturally with age, and that a number of benign conditions can also affect PSA levels, such as prostatitis , benign prostatic hyperplasia , urinary tract infection , or even injury to the prostate.
Other factors such as sexual activity right before testing, certain exercises, or even diet can impact the PSA levels as well. It is essential to consult a doctor regarding the meaning and next steps of your PSA testing results.
Biopsy During Surgery To Treat Prostate Cancer
If there is more than a very small chance that the cancer might have spread , the surgeon may remove lymph nodes in the pelvis during the same operation as the removal of the prostate, which is known as a radical prostatectomy .
The lymph nodes and the prostate are then sent to the lab to be looked at. The lab results are usually available several days after surgery.
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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:
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 it’s 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 can’t 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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What Are Additional Tests For Detecting Prostate Problems
If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging or computerized tomography scan.
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:
Prostate Cancer Urine Test
This test detects the gene PCA3 in your urine and can also help your doctorbetter assess your prostate cancer risk.
PCA3 is a prostate-specific noncoding RNA. Its a gene thats only in yourprostate. If the gene is overexpressed , then theres a greater chance you have prostate cancer.
Like PSA and PHI tests, this isnt definitive, either. But data suggestthat when cancer is present, the PCA3 will be positive 80 percent of thetime. This test can also help your doctor determine whether a biopsy isnecessary.
Both of these new tests are more accurate than the PSA test. Your doctormay recommend one or more than one, based on the specifics of your case.
How Is A Digital Rectal Exam Performed
A DRE is a physical exam of the prostate. The health care provider will ask the patient to bend over a table or lie on his side while holding his knees close to his chest. The health care provider slides a gloved, lubricated finger into the rectum and feels the part of the prostate that lies next to it. The DRE may be slightly uncomfortable, but it is brief. This exam reveals whether the prostate has any abnormalities that require more testing. If an infection is suspected, the health care provider might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first. Many health care providers perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.
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What Do The Numbers Mean
PSA levels are measured as a number of nanograms in each milliliter of fluid tested. This is written as ng/mL.
- PSA level 2.5 ng/mL or lower: This is a normal PSA level for men under age 60, but in some cases, prostate cancer may still be present.
- PSA level between 2.5 and 4 ng/mL: This is a normal PSA level for most men.
- PSA level between 4 and 10 ng/mL: This indicates that prostate cancer might be present. At this level, there is about a 25% chance that you have prostate cancer.
- PSA level 10 ng/mL or above: There is a 50 percent chance that prostate cancer is present. The higher the PSA rises above 10 ng/mL, the greater the chance that you have prostate cancer.
Your doctor may also monitor your PSA velocity, or doubling time, which means recording your baseline PSA the level at your very first PSA test and seeing how fast the PSA level increases over time. Rapid increases in PSA readings can suggest cancer. If your PSA is slightly high, you and your doctor may decide to keep an eye on your levels on a regular basis to look for any change in the PSA velocity.
How Is The Psa Test Used In Men Who Have Been Treated For Prostate Cancer
The PSA test is often used to monitor patients who have a history of prostate cancer to see if their cancer has recurred . If a mans PSA level begins to rise after prostate cancer treatment, it may be the first sign of a recurrence. Such a biochemical relapse typically appears months or years before other clinical signs and symptoms of prostate cancer recurrence.
However, a single elevated PSA measurement in a patient who has a history of prostate cancer does not always mean that the cancer has come back. A man who has been treated for prostate cancer should discuss an elevated PSA level with his doctor. The doctor may recommend repeating the PSA test or performing other tests to check for evidence of a recurrence. The doctor may look for a trend of rising PSA level over time rather than a single elevated PSA level.
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What’s A Raised Psa Level
The amount of PSA in your blood is measured in nanograms of PSA per millilitre of blood .
If you’re aged 50 to 69, raised PSA is 3ng/ml or higher.
A raised PSA level in your blood may be a sign of prostate cancer, but it can also be a sign of another condition that’s not cancer, such as:
Special Types Of Psa Tests
The PSA level from a screening test is sometimes referred to as total PSA, because it includes the different forms of PSA . If you decide to get a PSA screening test and the result isnt normal, some doctors might consider using different types of PSA tests to help decide if you need a prostate biopsy, although not all doctors agree on how to use these tests. If your PSA test result isnt normal, ask your doctor to discuss your cancer risk and your need for further tests.
Percent-free PSA: PSA occurs in 2 major forms in the blood. One form is attached to blood proteins, while the other circulates free . The percent-free PSA is the ratio of how much PSA circulates free compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not.
If your PSA test result is in the borderline range , the percent-free PSA might be used to help decide if you should have a prostate biopsy. A lower percent-free PSA means that your chance of having prostate cancer is higher and you should probably have a biopsy.
Many doctors recommend a prostate biopsy for men whose percent-free PSA is 10% or less, and advise that men consider a biopsy if it is between 10% and 25%. Using these cutoffs detects most cancers and helps some men avoid unnecessary biopsies. This test is widely used, but not all doctors agree that 25% is the best cutoff point to decide on a biopsy, and the cutoff may change depending on the overall PSA level.
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Men At Higher Risk Of Prostate Cancer
Some men are at higher risk of prostate cancer than others. These are:
- black men
- men who have a family history of prostate cancer
The risk of;prostate cancer also increases as men get older.
The evidence so far doesnt suggest that routinely screening these men would help prevent deaths from prostate cancer. In fact, it might lead to men having treatment for prostate cancer even though that cancer wouldnt have caused any problems or symptoms.
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