Should You Know Your Psa Level
Instead of a national screening programme, there is an informed choice programme, called prostate cancer risk management, for healthy men aged 50 or over who ask their GP about PSA testing. It aims to give men good information on the pros and cons of a PSA test.
If you’re aged 50 or over and decide to have your PSA levels tested after talking to a GP, they can arrange for it to be carried out free on the NHS.
If results show you have a raised level of PSA, the GP may suggest further tests.
How To Prepare For A Prostate Ultrasound
Ultrasound imaging of prostate tissue is a relatively simple procedure. Still, men should know how they can best prepare for the entire process. This helps to make the man more comfortable while they are undergoing the procedure.
There are not too many steps that a man can take to prepare for the procedure. There are, however, a few things that a man can do to make the entire procedure less inconvenient for themselves.
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Psa Test: The Current Prostate Screening Standard
Before recommending when you should be screened for prostate cancer, yourdoctor will consider many factors, such as:
- Family history, particularly whether any of your family members have had prostate cancer
- Race, as African-American men have a higher risk of developing prostate cancer
If your doctor determines you should undergo screening, he or she will mostlikely recommend the PSA test. For more than 30 years, the PSA test hasbeen the gold standard in prostate cancer screening. This simple blood testmeasures how much prostate-specific antigen is in your blood.
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When Should I Have My Psa Levels Tested
The first thing to do is talk to your doctor about the pros and cons of prostate cancer screening before you decide whether to be tested. Donât get tested until you have that talk. Opinions differ about when you should do that.
The American Cancer Society says to get tested at age:
- 40 or 45 if youâre at high risk
- 50 if youâre at average risk
The American Urological Association suggests:
- Under 40: No screening
- 40 to 54: No screening if youâre at average risk. If youâre at a high risk, you and your doctor can decide.
- 55 to 69: Screening if your doctor suggests
- Over 70 or less than a 10-15 year life expectancy: No screening
The U.S. Preventive Services Task Force says:
- 55 to 69: Men with prostate cancer risks may need testing.
If your doctor thinks you might have prostate cancer based on either a PSA level or a rectal exam, a biopsy is the next step. This is a test where the doctor takes a small amount of tissue from your prostate and sends it to a lab for tests. Itâs the only way to be sure you have cancer.
How To Prepare For An Accurate Psa Test
One of the most important factors in determining the accuracy and reliability of a medical test is how you, the patient, prepare for it. From fasting before certain blood tests to refraining from certain foods or medications, these criteria are vital for getting the most precise results possible.
A prostate specific antigen test for detecting elevated PSA levels possibly indicating prostate cancer, is one such procedure that relies on men preparing for and avoiding certain activities days before the actual test.
Like most screening tests, the PSA is a not a perfect test but it is still a necessary screening tool for detecting prostate cancer for all men beginning at age 40. PSA is a protein produced in the prostate gland and found at high concentrations in semen. The PSA test detects how much is spilling into the blood there should not be much. Elevated blood levels could be a sign of cancer but could also mean an enlarged prostate or a prostate infection.
Since the PSA value can change by 15-20% depending on how and when the test is administered, to improve the accuracy, there are certain things a man should avoid to get the most accurate reading possible. Here is a list of what men should not do before a PSA test:
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How Do I Prepare For A Prostate Ultrasound
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.
Lymph Node Biopsy As A Separate Procedure
A lymph node biopsy is rarely done as a separate procedure. Its sometimes used when a radical prostatectomy isnt planned , but when its still important to know if the lymph nodes contain cancer.
Most often, this is done as a needle biopsy. To do this, the doctor uses an image to guide a long, hollow needle through the skin in the lower abdomen and into an enlarged node. The skin is numbed with local anesthesia before the needle is inserted to take a small tissue sample. The sample is then sent to the lab and looked at for cancer cells.
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Serum Insulinlike Growth Factor
Insulinlike growth factor -1, its binding protein , and its receptor have been implicated in the development of prostate cancer. PSA cleaves IGF-1 from its binding protein, allowing this potent growth factor to act on prostate epithelial cells.
Plasma concentrations of IGF-1 have been associated with an increased risk of prostate cancer. In the Physiciansâ Health Study, 152 cases of prostate cancer were matched with 152 controls from the population of 14,916 physicians. Serum samples assayed for IGF-1 at the outset of the study found a positive association with the subsequent development of prostate cancer. Men in the highest quartile for IGF-1 had a relative risk of 2.4 as compared with men in the lowest quartile.
The predominant IGF-1 binding protein, IGFBP-3, has growth-inhibiting properties that diminish the effect of IGF-1. After correcting for IGFBP-3 levels, the risk of developing prostate cancer was 4.5 times greater for the highest quartile than for the lowest quartile.
The clinical usefulness of this assay has yet to be demonstrated, because alternative explanations for these findings may exist. Prostate size and a large overlap in actual values limit the utility of the test but do provide additional information regarding the biology of prostate cancer.
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What Other Screening Tests Are Used To Detect Prostate Cancer
Because a biopsy is an invasive procedure, your doctor may first use one or more of the following methods to screen for prostate cancer:
Medical history
When your doctor takes a detailed medical history, they may ask you about your symptoms, underlying health conditions and whether you consume alcohol or tobacco in any form. Your doctor may also ask you whether any of your close family members such as a father, uncle or brother were diagnosed with prostate cancer at a young age . You may also be asked other questions such as whether you have experienced weight loss or a change in sex drive.
Digital rectal examination
A thorough physical examination will also allow your doctor to assess your general health by looking for any signs of disease.
Your doctor may order a digital rectal examination . During a DRE, your doctor will insert a gloved, lubricated finger into your rectum and try to feel for any lumps, irregularities or hard areas on the prostate that could suggest cancer. This examination will also provide clues as to whether the cancer is in one or both sides of the prostate and whether it has spread to the nearby structures.
Prostate-specific antigen blood test
Your doctor may order blood tests to look for blood counts or inflammatory markers . One blood test may measure the levels of a type of protein called PSA, which is made by both normal and cancerous cells in the prostate.
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What Does Psa Mean
PSA, or prostate-specific antigen, is a protein produced by the prostate and found mostly in semen, with very small amounts released into the bloodstream. When theres a problem with the prostatesuch as the development and growth of prostate cancermore PSA is released. Sometimes, a mans prostate releases slightly high PSA for other reasons. Rising PSA eventually reaches a level where it can be easily detected by a blood test.
For more information on rising PSA, download or order your free copy of the Prostate Cancer Patient Guide.
Do False Negatives And False Positives Happen
The PSA test is not a fool-proof method to test for prostate cancer.
When prostate cancer develops, PSA levels often rise about 4.0 ng/mL, but there are exceptions to the rule.
A showed that some people with PSA levels below 4.0 ng/mL had prostate cancer, while some with higher levels did not.
The ACS states that about of people with a PSA below 4 will have prostate cancer.
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Private Prostate Cancer Testing
Are you considering getting a private prostate cancer test? We can help.
to learn about how we diagnose and treat prostate cancer at The Royal Marsden, Private Care at Cavendish Square.
We offer consultant-led appointments, assessments and diagnostics all on the same day. Do you want to book a consultation at our one-stop urological cancer service? .
Should You Get A Psa Test
Most people with penises will get a PSA test in their lifetime. Depending on your age and risk factors, your doctor may encourage one.
Organizations, like the U.S. Preventive Services Task Force , have laid out recommendations for those considering a screening.
The USPSTF recommends the following for those who have an average or increased risk of prostate cancer, do not have symptoms of prostate cancer, and have never been diagnosed:
- If youre 55 to 69 years old, you should make an individual decision whether you want to take a PSA test.
- Before making a decision, you should talk with your doctor about the including the benefits and harm of other tests and treatment.
- If youre age 70 or older, you should not be screened for prostate cancer routinely.
The suggests you also consider the following when talking with your doctor prior to screening:
- if you have a family history of prostate cancer
- if youre African American
- if you have other medical conditions that may make it difficult to treat prostate cancer if its found
- how you value the potential benefits and harms of screening, diagnosis, and treatment
- access to nurses to discuss your results
Cons:
- takes up to 5 days to get results
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- Insurance coverage: FSA and HSA accepted
Pros:
Cons:
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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.
What If The Psa Is Elevated Then What
Men with an elevated PSA do not necessarily indicate prostate cancer. There are other causes for an elevated PSA that include:
- Enlarged prostate or benign prostatic hyperplasia
Dr. David Samadiis the Director of Mens Health and Urologic Oncology at St. Francis Hospital in Long Island. Hes a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadis Guide to Mens Health and Wellness, available online both on and Barnes & Noble. Visit Dr. Samadis websites at robotic oncolo gy and prostate cancer 911.
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If You Are Transgender
If you are a trans man you do not have a prostate and do not need a PSA test.
Trans women and non-binary people assigned male at birth still have a prostate gland, whether they have had genital gender-affirming surgery or not. This means they may still get prostate cancer, although there is not enough evidence to know how common this is.
If you are a trans woman or non-binary person assigned male at birth and would like to have the PSA test, talk to your GP.
You may worry about talking to your doctor or practice nurse about this, but they are used to talking about many different needs. If you find it difficult to start the conversation, you could try showing them this information. You should talk about any worrying symptoms or concerns with your GP or nurse.
Prostate cancer UK have detailed information about trans women and prostate cancer.
The LGBT Foundation can also give you confidential advice and support. You can also talk to one of our cancer support specialists.
What Are Some Of The Limitations And Potential Harms Of The Psa Test For Prostate Cancer Screening
Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors. Having a small tumor found and treated may not, however, reduce the chance of dying from prostate cancer. That is because many tumors found through PSA testing grow so slowly that they are unlikely to be life threatening. Detecting such tumors is called overdiagnosis, and treating them is called overtreatment.
Overtreatment exposes a person unnecessarily to the potential complications associated with prostate surgery and radiation therapy. These include urinary , gastrointestinal , and sexual side effects .
In addition, finding cancer early may not help someone who has a fast-growing or aggressive prostate tumor that may have spread to other parts of the body before being detected.
The PSA test may give false-positive results. A false-positive test result occurs when the PSA level is elevated but no cancer is actually present. A false-positive test result may create anxiety and lead to additional medical procedures, such as a prostate biopsy, that can be harmful. Possible side effects of biopsies include serious infections, pain, and bleeding.
False-positive test results are common with PSA screening only about 25% of people who have a prostate biopsy due to an elevated PSA level are found to have prostate cancer when a biopsy is done .
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Screening Tests For Prostate Cancer
Screening is testing to find cancer in people before they have symptoms. Its not clear, however, if the benefits of prostate cancer screening outweigh the risks for most men. Still, after discussing the pros and cons of screening with their doctors, some men might reasonably choose to be screened.
The screening tests discussed here are used to look for possible signs of prostate cancer. But these tests cant tell for sure if you have cancer. If the result of one of these tests is abnormal, you will probably need a prostate biopsy to know for sure if you have cancer.
What This Means For You
The Prostate Cancer UK spokesperson sounds a note of caution for now, pointing out that until these studies have been conducted, we don’t have enough information about its benefits.
“This innovative testing method is an interesting new approach, but there simply hasn’t been enough detailed research into its effectiveness for us to be able to recommend for its use at this stage,” he says. “Until then, we would not recommend that anyone use this test as a substitute for current standard methods.”
Of course, research in the field will be continuing apace.
“In order to save more lives from prostate cancer it is crucial that we create a diagnostic process that is robust enough to routinely diagnose men early and accurately,” says the spokesperson.
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What Do The Results Mean
Your results will share the nanograms per milliliter of PSA in your blood. This biomarker has stirred controversy over the years because there is no number considered normal. Typically, a PSA of 4 or higher would show an increased risk of prostate cancer.
According to the organization Zero Cancer, general PSA guidelines are:
- 0 to 2.5 ng/mL is considered safe.
- 2.6 to 4 ng/mL is safe for most, but you should talk with your doctor about other risk factors.
- 4.0 to 10.0 ng/mL is suspicious and might suggest the possibility of prostate cancer. Its associated with a 25 percent chance of having prostate cancer.
- 10.0 ng/mL and above is dangerous and should be discussed with your doctor immediately. Its associated with a 50 percent chance of having prostate cancer.
Its important to understand that this is not always the case. Some people with lower levels of PSA may have prostate cancer, and some people with higher levels of PSA might not have cancer. The PSA test is simply the first marker of prostate enlargement and cell activity.