What Is A Tsa Blood Test
Tests for tumor-specific antigen help diagnose cancer or monitor the effects of treatment in people who have been diagnosed with cancer, explains the National Cancer Institute. As of February 2015, there are more than 20 different tumor markers.
Cancer cells produce substances called tumor markers, states the National Cancer Institute. These markers are found in the blood, waste products and body fluids. Each tumor marker is associated with specific types of tumors. Cancer antigen 19-9 levels may be elevated in cases of gallbladder cancer, stomach cancer or pancreatic cancer. One of the tests used to diagnose ovarian cancer is cancer antigen 125. Some benign conditions cause elevated tumor marker levels, so a high level of a certain cancer antigen is not an absolute indicator of cancer.
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.
When Should I Get A Psa Test
The guidelines below are adapted from the NCCN Clinical Practice Guidelines In Oncology for Prostate Cancer Early Detection. Please use these guidelines to have a discussion with your physician about your personal risk and make a plan for screening.
- If you are between ages 45 and 75:
- Discuss the risks and benefits of prostate cancer screening with your doctor, have a baseline PSA, and consider a baseline DRE
- If your PSA is below 1 ng/mL and your DRE is normal, repeat testing every 2-4 years
- If your PSA is between 1 and 3 ng/mL and your DRE is normal, repeat testing every 1-2 years
- If your PSA is greater than 3 ng/ML or your DRE is very suspicious, your doctor may suggest additional testing or a biopsy
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If Screening Test Results Arent Normal
If you are screened for prostate cancer and your initial blood PSA level is higher than normal, it doesnt always mean that you have prostate cancer. Many men with higher than normal PSA levels do not have cancer. Still, further testing will be needed to help find out what is going on. Your doctor may advise one of these options:
- Waiting a while and having a second PSA test
- Getting another type of test to get a better idea of if you might have cancer
- Getting a prostate biopsy to find out if you have cancer
Its important to discuss your options, including their possible pros and cons, with your doctor to help you choose one you are comfortable with. Factors that might affect which option is best for you include:
- Your age and overall health
- The likelihood that you have prostate cancer
- Your own comfort level with waiting or getting further tests
If your initial PSA test was ordered by your primary care provider, you may be referred to a urologist for this discussion or for further testing.
Pros And Cons Of The Psa Test
Pros:
- it may reassure you if the test result is normal
- it can find early signs of cancer, meaning you can get treated early
- PSA testing may reduce your risk of dying if you do have cancer
Cons:
- it can miss cancer and provide false reassurance
- it may lead to unnecessary worry and medical tests when there’s no cancer
- it cannot tell the difference between slow-growing and fast-growing cancers
- it may make you worry by finding a slow-growing cancer that may never cause any problems
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What Happens During A Digital Rectal Exam
Your health care provider will insert a gloved finger into the rectum and feel the prostate for hard, lumpy, or abnormal areas. The test takes only a few minutes to complete.
You may feel slight, momentary discomfort during the test. The procedure does not cause significant pain or any damage to the prostate.
The Role Of Psa In Staging
Prostate cancer causes cells to become malignant and multiply uncontrollably. This can lead to overproduction of PSA, and higher levels of PSA in the bloodstream.
However, some men who have prostate cancer do not exhibit elevated PSA levels. And certain noncancerous conditions, like a prostate infection or benign enlargement, can also cause high PSA levels.
PSA levels are just one factor used in determining the stage of prostate cancer. Another diagnostic tool is called the Gleason scale. This rates the extent of abnormality in your prostate cells after biopsy.
At a certain point in prostate cancers late-stage progression, Gleason and PSA become less useful. When a tumor is large enough, doctors no longer need these numbers to predict its growth or malignancy.
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Is The Psa Test Recommended For Prostate Cancer Screening
Beginning around 2008, as more was learned about both the benefits and harms of prostate cancer screening, a number of professional medical organizations began to caution against routine population screening with the PSA test. Most organizations recommend that individuals who are considering PSA screening first discuss the risks and benefits with their doctors.
Some organizations do recommend that men who are at higher risk of prostate cancer begin PSA screening at age 40 or 45. These include Black men, men with germline variants in BRCA2 , and men whose father or brother had prostate cancer.
In 2018, the United States Preventive Serves Task Force updated its recommendation statement for prostate cancer screening from a D to a C in men ages 55 to 69. The updated recommendation, which applies to the general population as well as those at increased risk due to race/ethnicity or family history, is as follows:
- For individuals ages 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one. Before making the decision, a person should discuss the potential benefits and harms of screening with their clinician and consider these in the context of their own values and preferences.
- PSA-based screening for prostate cancer is not recommended for individuals 70 years and older.
What Do The Results Mean
High PSA levels can mean cancer or a noncancerous condition such as a prostate infection, which can be treated with antibiotics. If your PSA levels are higher than normal, your health care provider will probably order more tests, including:
- A rectal exam. For this test, your health care provider will insert a gloved finger into your rectum to feel your prostate.
- A biopsy. This is a minor surgical procedure, where a provider will take a small sample of prostate cells for testing.
If you have questions about your results, talk to your health care provider.
Learn more about laboratory tests, reference ranges, and understanding results.
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What Causes An Elevated Psa Level
Prostate cancer is the main cause of an elevated PSA level. But PSA levels increase with age and can reflect different prostate conditions. Other factors that may raise a persons PSA level include:
- Prostate enlargement and inflammation .
- Urinary tract infection.
- Urinary catheter placement.
Your healthcare provider will also consider whether your medications affect PSA levels. For example, 5-alpha reductase blockers treat enlarged prostates and will lower PSA levels.
What Should I Expect If Im Told I Have Elevated Psa
If your provider finds an elevated PSA level, youll have repeat tests to check your prostate. Many men with elevated PSA levels even those who have prostate cancer live long, healthy lives. Prostate cancer may not need treatment, depending on how slowly the tumor is growing. Keep up with your regular appointments and tests so your care team can keep tabs on your health.
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Does My Psa Level Determine Whether I Have Prostate Cancer
Your provider looks at two factors related to your PSA:
- Your PSA level: A higher level means a higher risk of prostate cancer.
- A continuous rise: PSA levels that continue to rise after two or more tests may mean you have cancer.
But the PSA level alone doesnt determine if you have cancer or not. Two men can even have the same PSA levels but different risks of prostate cancer. And a high PSA level may reflect prostate problems that arent cancer.
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.
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Psa Levels By Age Chart
The main difference between the PSA scores of prostatitis and an enlarged prostate, compared to prostate cancer, is the ratio of free vs bound PSA within your test sample.
- Prostate Cancer will have a higher bound PSA ratio.
- An enlarged prostate and prostatitis will have a higher free PSA ratio.
- If your free PSA results are less than 25%, your risk for developing prostate cancer is between 10% to 20%.
- If your free PSA results are less than 10%, your risk for developing prostate cancer jumps to around 50%.
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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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.
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.
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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 screeningexternal icon 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.
If you are thinking about being screened, learn about the possible benefits and harms of screening, diagnosis, and treatment, and talk to your doctor about your personal risk factors.
There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.
What The Research Says
Two long-awaited studiesone conducted in the United States and the other in Europewere supposed to help settle the debate over the value of PSA testing. Instead, the trials, published in the New England Journal of Medicine in March 2009, seemed to come to opposite conclusions. The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial reported no survival benefit with PSA screening and digital rectal examination, but the European Randomized Study of Screening for Prostate Cancer found a 20% reduction in prostate cancer deaths. The ERSPC study estimated that for every life saved, 48 men are treated and 1,068 men are screened.
The debate over the effectiveness of PSA screening has quickly filtered into the offices of general practitioners and urologists. On a daily basis, confused men are asking their doctors: “Should I have a PSA test or not?”
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What Is A Psa Test
The PSA test is the leading method of screening for prostate cancer. PSA screening can help catch the disease at an early stage when treatment may be more effective and potentially have fewer side effects. The PSA test may be done along with a digital rectal exam , in which a physician inserts a gloved finger into the rectum to examine the prostate for irregularities.
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.
04/2014
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Psa Test For Early Detection Of Prostate Cancer
Prostate cancer whose malignancy develops in the prostate has similar symptoms with benign prostatic hyperplasia which is a benign prostate enlargement disease often found in elderly men. Because the symptoms are difficult to distinguish, a test is needed to detect them early as well to distinguish between prostate cancer and BPH.
The American Cancer Society recommends a prostate cancer screening to men of age 50 years or more. If there is a family history of prostate cancer, screening is recommended from the age of 40 years. The most common tests to detect prostate cancer are:
– Digital rectal
DRE is conducted by a trained doctor by touching the prostate via rectum with a lubricated index finger. If during palpation a lump with irregular shape or a hardening section on the surface of the gland is found, prostate cancer might have developed.
– Prostate specific antigen test
The PSA test is a blood test conducted by measuring the levels of total PSA.
PSA is a protein produced by the prostate, and serves as a diluent to the semen so that sperm is more fluidly. In normal condition, only a little amount of PSA might enter the bloodstream. When there is an inflammation or damage in the prostate tissue, the level of PSA in the blood elevates.
To distinguish whether or not the increased levels of total PSA are caused by prostate cancer, you are recommended to take a ratio test of free-PSA/total PSA, especially for those whose total PSA level is between 2.6-10 ng/ml.