What is PSA in Prostate Cancer? Everything You Need to Know

Prostate cancer is one of the common cancers among men. Diagnosing early can help in monitoring the treatment with a proper care which increases the chances of having successful treatment. PSA test is one of the reliable technique for diagnosing and monitoring the stage of prostate cancer. If you are wondering what PSA is and how it relates to prostate cancer, this blog will cover what is PSA in prostate cancer?

What is PSA in Prostate Cancer?

Prostate-Specific Antigen (PSA) is a protein produced by cells of the prostate gland, a small organ located below the bladder in men. It is found in small amounts in the blood of healthy men, but its levels can rise due to prostate conditions like inflammation, enlargement or cancer.

How Does the PSA Test Work?

The PSA test is a simple blood test that measures the level of PSA in the blood. Doctors use it as a screening tool to identify men who might be at risk for prostate cancer. The test doesn’t confirm cancer by itself, but high PSA levels can indicate the need for further investigation, such as a biopsy or imaging tests.

What is a Normal PSA Level?

PSA levels are measured in nanograms per milliliter (ng/mL) usually:

• PSA levels below 4 ng/mL are considered normal.
• PSA levels ranging from 4 to 10 ng/mL may indicate an elevated risk of prostate cancer.
• PSA levels above 10 ng/mL indicates the high risk of prostate cancer.

However, PSA levels can vary due to age, genetics and other health conditions.

The Role of PSA in Prostate Cancer Detection

The PSA test is a game-changer in detecting prostate cancer early. Before its widespread use, most prostate cancer cases were diagnosed at advanced stages when treatment was less effective. Today, PSA screening helps identify cancer when it is localized and more treatable.

What Causes Elevated PSA Levels ?

High PSA levels don’t always mean cancer. Here are some common reasons for high PSA:

• Prostate Cancer: Cancer cells in the prostate produce more PSA than normal cells which can cause a rise in blood PSA levels.
• Benign Prostatic Hyperplasia (BPH): An enlarged prostate can produce more PSA, even though it is not cancerous.
• Prostatitis: Inflammation or injection in the prostate can lead to elevated PSA levels.
• Ejaculation or Recent Sexual Activity: Sexual activity should be avoided before going for a PSA test as it can raise PSA levels.
• Prostate Procedures: Medical procedures like a prostate biopsy or digital rectal exam (DRE) can also increase PSA levels.
• Age: PSA levels naturally increase as men age, even in the absence of disease.

Limitations of the PSA Test

PSA test also has some limitations:

• False positives: High PSA  levels don’t always mean cancer. They can also result from (benign prostatic hyperplasia) or prostatitis (inflammation of the prostate).
• False negatives: Some men with prostate cancer may have normal PSA levels, leading to missed diagnoses.
• Overdiagnosis: PSA screening can detect slow-growing cancers that may not cause harm during a man’s lifetime. Treating these cancers unnecessarily can lead to side effects like urinary incontinence and erectile dysfunction.
• Unclear Results: PSA  results must often be interpreted alongside other tests, like a biopsy to confirm a diagnosis.

The Role of PSA in Monitoring Prostate cancer

For men already diagnosed with prostate cancer, PSA testing plays a critical role in monitoring the disease. Doctors check PSA levels regularly to see how the cancer is responding to treatment.

After treatments like surgery or radiation, PSA levels usually drop significantly. A rising PSA level after treatment may suggest that the cancer has returned, promoting further tests and action.

The Role of Lifestyle in Prostate Cancer Risk

While PSA testing is essential for early detection, lifestyle changes can also reduce the risk of prostate cancer. Here are some steps men can take:

• Maintain Healthy Diet: Maximize the consumption of fruits, vegetables, lean proteins, and whole grains.
• Stay Active: Regular exercise helps maintain a healthy weight and may lower cancer risk.
• Avoid Smoking: Smoking has been linked to more aggressive forms of prostate cancer.
• Limit Alcohol: Drinking in moderation can help maintain overall health.
• Stay Hydrated: Drinking plenty of water helps maintain urinary and prostate health.
• Discuss Medications: Some medications can affect PSA levels. Speak to your doctor if you are on any drugs, especially those for an enlarged prostate.

PSA Testing and Prostate Cancer Treatment

Men who are diagnosed with prostate cancer, PSA testing continues to play an essential role:

• Before Treatment: PSA levels assist doctors in evaluating the severity of the cancer and formulating a proper treatment plan.
• During Treatment: Regular PSA tests help in track the treatment’s outcomes.
• After Treatment: An increase in PSA levels following treatment may indicate a recurrence, requiring further investigation.

What Happens if PSA Levels are High?

If your PSA levels are high, your doctor may recommend further testing, such as:

• Digital Rectal Exam (DRE): A physical exam where the doctor checks the prostate for abnormalities.
• Imaging tests: MRI or ultrasound may provide more detailed information about the prostate.
• Prostate Biopsy: A biopsy involves removing a small sample of prostate tissue to check for cancer.
• Additional PSA tests: Repeating the PSA test after a few weeks may confirm if the elevation is temporary or persistent.

Best hospitals for PSA test and prostate cancer treatments in India

• Fortis Hospital, Bangalore
• MGM Healthcare, Chennai
• Venkateshwar Hospital, New Delhi
• Batra Hospital and Medical Research Centre, Delhi
• BLK Super Specialty Hospital, Delhi
• Max Super Specialty Hospital, Delhi
• Medanta the Medicity, Gurgaon
• Care Institute of Medical Sciences, Ahmedabad
• Gleneagles Global Hospital, Hyderabad
• Lilavati Hospital and Research Centre, Mumbai

Conclusion:

PSA testing is a vital diagnostic procedure for fighting against prostate cancer. While it has few limitations, it can also detect cancer early and help in taking treatment decisions, improving survival rates. If you’re going for a PSA test, ensure you’re aware of the risk factors associated with it and treatment options with your doctors. Prostate health is crucial for men’s well-being and staying informed is the first step towards it.

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