Prostate Specific Antigen (PSA)

This is a blood test to look for a substance which is increased in males who have prostate cancer. The test has a relatively high false positive rate (elevated PSA, but the person does not have prostate cancer) but serves as a useful screening test. PSA can be elevated in nonserious conditions such as benign prostatic enlargement.

Because this test is fairly specific for individuals who may have prostate cancer, those with elevated PSA should undergo further examination using ultrasound of the prostate gland (to look for tumor). The availability of the PSA test has caused some dilemma among Urologists and Oncologists because of the ability to diagnose, in relatively young men, extremely small prostate cancers.

The resultant decisions on whom to treat, and when to treat (previously undetected cancers), becomes an issue. In some cases, prostate cancer treatment can lead to sexual dysfunction (impotence).

The PSA is now widely recognized as a primary screening tool for prostate cancer and the American Cancer Society recommends annual testing after the age of 50. High risk groups such as African Americans and those with a family predisposition for prostate cancer should be have this test performed annually after age 40.

PSA BLOOD LEVELS (nanograms per milliliter): The normal range is: 0-4 ng/ml Suspicious: 4-10 ng/ml (monoclonal) or > 7 ng/ml (polyclonal) Highly Suspicious: > 10 ng/ml

NOTE: (Proscar), used in the treatment of prostate enlargement, has been shown to decrease the serum PSA level.


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