Elevated PSA
What is PSA?
Prostate-specific antigen (PSA) is a protein produced by both noncancerous (benign) and cancerous prostate tissue. It is normal to have a small amount of PSA entering the bloodstream. Prostate cancer cells can produce more PSA than benign cells, causing the blood PSA levels to rise.
Unfortunately, there is no normal reading and other conditions such as enlarged prostate (BPH), infection or inflammation may also cause an elevated PSA reading. It is important to monitor PSA levels over a period of time, rather than a single reading.
What is PSA screening?
PSA screening involves a blood test to establish the individual risk of prostate cancer. It may help identify prostate cancer at an early stage, when treatment is most effective and to improve the chances of cure. Prostate cancer screening is perfumed because prostate cancer causes no symptoms in the early stages.
PSA testing is sometimes combined with a digital rectal exam (DRE) to feel the prostate for abnormalities.
Factors that Affect PSA
A number of factors need to be considered before evaluate your PSA levels, including:
Age
Size of the prostate gland
How quickly the PSA is changing
Some medications can affect PSA levels
Family history of prostate cancer
What are the benefits of PSA screening?
PSA screening may detect early stage prostate cancer. Detecting certain types of prostate cancer early can be critical. In particular, elevated PSA may reveal aggressive prostate cancer that is more likely to grow rapidly and spread to other parts of the body (metastasis).
Early detection allows early treatment of aggressive cancer before the cancer becomes causes serious problems or becomes life-threatening.
Are there any risks with PSA screening?
You may wonder why PSA screening would have any downsides. The test itself is just simple blood test in the lab and carries little risk. The potential downsides are:
PSA levels can be elevated from other causes such as enlarged prostate (BPH), infection or inflammation (false positive result)
Some prostate cancers do not produce much PSA. It is possible to have a low PSA that may be falsely reassuring for these rarer types of prostate cancer (false negative result).
Low risk prostate cancer can be watched with active surveillance in some patients. Despite appropriate counseling, some patients may find living with a slow-growing prostate cancer stressful and anxiety-provoking.
Who should have PSA screening?
Men who are interested in establishing their individual risk of having prostate cancer should discuss the pros and cons of PSA screening with their GP or Urologist. Deciding to have PSA screening is a personal choice. The benefits of screening are early detection which then allows for early treatment and cure. Various guidelines exist for PSA screening. At Adelaide Urology Care, we support the position of the Urological Society of Australia and New Zealand and the Prostate Cancer Foundation of Australia.
In general, the recommendation is to have PSA screening:
Every 2 years from 50 years of age
Every 2 years from 45 years of age if a family history of prostate cancer
Every 2 years from 40 years of age if a strong family history of prostate cancer
What if the PSA screening is elevated?
If your PSA screening test is elevated, Adelaide Urology Care will provide a comprehensive assessment of your individual risk to determine the need for further investigation. Further investigations may include repeat PSA testing, prostate MRI imaging and/or prostate biopsy to rule out prostate cancer.
If you are diagnosed with prostate cancer, we will ensure you are fully informed of all the treatment options and work with you to develop a personalised treatment plan. Whether you choose active surveillance or robotic prostate surgery, our goal will be to provide you the highest level of care and expertise.
Contact
At Adelaide Urology Care, we are dedicated to giving you the personalised care you need. We support a discussion of PSA screening evaluating your risk factors and your personal preferences. Please do not hesitate to contact us for more information.
