Overview

The prostate-specific antigen (PSA) test is included in all checkups for men over 50 years old. For men who have a family history of prostate cancer or other cancer, this test should be taken starting at age 40.

The PSA test is used in the following cases:

• Suspicion of benign or malignant processes, inflammation of the prostate, structural changes in its tissues
• Hyperplasia of the prostate detected by ultrasound
• Complaints of difficulty, painful and/or frequent urination
• Increase in the size, consistency, and structure of the prostate detected by rectal examination or ultrasound

The prostate-specific antigen itself is secreted by prostate tissue. Its purpose is to liquefy sperm. Therefore, PSA is always present in the blood of a healthy man, but its concentration should not go beyond the established normal values of 0–4 ng/ml. When PSA levels rise above that, health issues become more likely.

The probability of detection of cancer, based on PSA level: Up to 10 ng/ml — suspected prostate cancer 10–20 ng/ml — high risk of prostate cancer 20–50 ng/ml - the risk of disseminated prostate cancer 50–100 ng/ml — high risk of metastases to lymph nodes and distant organs more than 100 ng/ml — metastatic prostate cancer

Keep in mind that the index may change with age, and the older a man is, the greater the deviation — even if he is healthy. Additionally, some factors can affect the reliability of the result.

Why the test can be wrong

Many people do not know that the test must be taken after at least 48 hours of no sexual activity. In addition, false-positive results may appear after intense physical activity, taking certain medications, and any manipulation of the prostate gland from massage to ultrasound. In addition, the total PSA level is elevated if the patient has:

• Prostate ischemia or infarction
• Diseases of the genitourinary organs
• Prostatitis in acute or chronic form
• Benign neoplasms (cysts, adenomas, polyps, etc.)

Conclusion

If you believe you may have prostate issues, make an appointment with your doctor as soon as you can. Your doctor will examine you and determine whether a PSA test is necessary.

02 December 2021