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PSA Test: Prostate Specific Antigen Test For Prostate Cancer Screening


PSA Test

Prostate-specific antigen (PSA) is a protein produced by both cancerous and non-cancerous cells in the male prostate gland. Most of the PSA amount produced by the prostate gland is carried out of the body in semen, and only a small amount escapes into the bloodstream. PSA is generally found in low amounts (nanograms per millilitre or ng/mL) in the blood.

PSA test is a blood test primarily used in the screening of prostate cancer. The PSA test can detect elevated PSA levels, which may be an indication of prostate cancer and many other conditions like enlarged or inflamed prostate. Therefore, determining the reason for the rise of PSA levels may be a complication.


How Does the Urinary System Work?

The body takes nutrients from the food eaten and converts them to the energy required for various body functioning. After the body has taken the essential food components, the waste products are left behind in the bowel and in the blood.

The urinary system helps the body to remove liquid waste called urea and keeps the chemicals, such as potassium and sodium and water in a healthy amount. In our body, urea is produced when foods containing protein, such as meat, poultry, and few vegetables, are metabolized. Urea is carried in the blood to the kidneys, where it is eliminated along with water and other waste products in the form of urine.


Why is PSA (Prostate Specific Antigen) test done?

Prostate cancer is common, and a persistent cause of cancer death. Early detection may be an important tool in getting proper and timely treatment. Men having prostate cancer may have higher levels of PSA. However, many noncancerous conditions can also increase the PSA level. The prostate-specific antigen test can detect high levels of PSA in the blood but does not provide precise diagnostic information about the status of the prostate gland. The test is considered only as one of the tools used in screening for early signs of prostate cancer.

Another standard screening test, usually done in addition to a test, is a digital rectal exam. In this test, the doctor inserts a lubricated, sterile gloved finger into your rectum to examine the prostate. By feeling or pressing on the prostate, the doctor may be able to judge whether it has abnormal lumps or stiff areas. Neither the test nor the digital rectal exam provides enough information for doctors to diagnose prostate cancer. After finding abnormal results in these tests, the doctor may recommend a prostate biopsy. During this procedure, samples of tissue are taken for laboratory examination. A diagnosis of cancer is based on biopsy results.

Other reasons for the PSA test are:

  • Monitor the effectiveness of an ongoing treatment
  • Check the reoccurrence of cancer

How is PSA Measured?

PSA test is a simple blood test that requires no prior preparation like fasting. The PSA protein found in the blood by itself is known as free PSA, and it can also exist bounded with other substances known as bound PSA. 

Both of them determine the PSA levels in the blood. Total PSA test estimates all the PSA, which includes antigens that are bound and unbound, i.e. free-floating antigens. Free PSA tests measure the concentration of unbound or free-floating antigens in the bloodstream.


Normal PSA Levels

The is no specific normal or abnormal levels of PSA in the blood. The prostate gland generally enlarges in size and produces more PSA with growing age, so it is reasonable to have lower levels in young men and higher levels in older men. Due to these normal changes in PSA with age, the concept of age-adjusted PSA has been described and recommended.


Elevated PSA Levels

Elevation of PSA levels in the blood is due to its release in the bloodstream due to the disruption of the prostate cellular structure. An increased PSA level can be possible in cases of different prostate diseases as well as conditions, including prostate cancer. It is important to mark that PSA is not specific to prostate cancer but prostatic tissue, and therefore, the fluctuation in the levels may indicate any prostatic disease.

Major benign causes of PSA elevation comprise benign prostatic hyperplasia (BPH), prostatitis, and urinary tract infections. PSA elevation can also occur with prostate manipulation like prostate examination, cystoscopy, prostate biopsy, and urinary retention. It is also believed that various types of vigorous exercises like riding a bicycle may enhance the PSA level.


How is PSA Used for the Early Detection of Prostate Cancer?

Medically confined prostate cancer is usually asymptomatic (with no symptoms). In general, most males with early and localized prostate cancer have PSA values of less than 20 ng/mL. Once this limit raises, the risk of spreading of the disease increase significantly. People with early prostate cancer usually feel fine and have no urinary symptoms related to prostate cancer. Though prostate cancer is diagnosed by the presence of cancerous prostatic cells in a prostate biopsy, elevated PSA will remain the most common screening for prostate cancer which may be followed by further tests.

It is also important to keep in mind that not all men with prostate cancer have elevated PSA levels. This is the reason why health care professionals may use low thresholds to make sure when to do a biopsy, depending on the presence of the risk factors like family history, PSA density, and PSA velocity.


Free PSA Test

Free PSA tests are used alongside other PSA tests to confirm the diagnosis results. The test evaluates the levels of an unbound Prostate Specific Antigen in the blood, which may be helpful for the doctors to detect problems like any inflammation in the prostate gland. A free PSA test can also be used before a biopsy if the doctor suspects prostate cancer.


Difference Between “Free PSA” and “PSA”

PSA can have two known states: it may be bound or free-floating.

Both total PSA and free PSA tests measure levels of PSA in the blood. Results helps doctors to diagnose issues such as prostate cancer and any kind of inflammation in the prostate gland. These two tests are slightly different. A total PSA test measures all the PSA, including the antigens that are bound and those that are unbound or free-floating. While free PSA test only measures the amount of PSA that is floating freely in the bloodstream without being bound to any protein. Both tests are used to detect prostate issues.


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DATA SOURCES:

  • https://www.medicinenet.com/prostate_specific_antigen/article.htm
  • https://www.mayoclinic.org/tests-procedures/psa-test/about/pac-20384731



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PSA Test: Prostate Specific Antigen Test For Prostate Cancer Screening
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PSA Test: Prostate Specific Antigen Test For Prostate Cancer Screening
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Read about PSA test, elevated PSA levels, normal PSA level, why test is done, The PSA test is a blood test used primarily to screen for prostate cancer. It measures the amount of prostate-specific antigen (PSA) in your blood.
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