What is PSA?
Prostate-specific antigen (PSA) is a protein that is naturally produced by the prostate gland. The prostate gland slowly grows over a male’s lifetime. As the prostate gland grows, it may increase the production of PSA.
What Is a Normal Level?
Dr. Stisser explains, “there is still much that is unknown about PSA, including why some men naturally produce higher levels than others.” As a standard, urologists agree that a PSA level under 2ng/ml in men over the age of 50 is acceptable and not cause for concern.
Urologists become concerned when a patient has a PSA level greater than 3ng/ml as this may indicate other underlying health concerns.
Other Testing & Concerns
Patients with an elevated PSA can expect their urologists to perform a digital rectal exam which allows the urologist to palpate the prostate and evaluate the size and position. This exam can help determine the presence of benign prostatic hyperplasia (BPH), or enlargement of the prostate gland. It is common to see a level of 3-4ng/ml or greater when BPH is present.
Prostatitis, an infection of the prostate, can also cause an elevated PSA. Prostatitis can cause swelling and irritation of the prostate and surrounding tissue. Other symptoms of prostatitis include flu-like symptoms paired with painful urination, lower back pain, and an inability to empty the bladder. While prostatitis is often caused by a bacterial infection, it is not contagious and is not a sexually transmittable disease. Patients can expect to undergo antibiotic therapy, which may include hospitalization for intravenous antibiotic in severe cases.
An elevated PSA can be a warning sign of prostate cancer. In fact, considering the patient’s age; the higher the PSA, the greater the risk of prostate cancer. Because of this, urologists will likely recommend a biopsy of the prostate in patients with a PSA greater than 3-4ng/ml in an attempt to detect cancer cells in the early stages of development.
PSA Levels During and After Cancer Treatment
Not only can PSA be helpful for diagnosing prostate cancer, but it can also assist in monitoring the effectiveness of treatment. As a patient undergoes treatment for prostate cancer, his PSA will typically lower with the absence of the cancer cells. Patients who have radical prostatectomies, the total removal of the prostate, will generally have a PSA drawn six to eight weeks after surgery. Depending on the level at that time, the urologist will determine how frequently the PSA needs to be drawn in the coming weeks and months. Patients who decide to keep their prostates, and opt for alternative treatments such as radiation or chemotherapy, can expect to see a gradual decline in PSA over several months. The normal timeframe depends on the specific therapy.
Problems with PSA Testing
According to Dr. Stisser, “PSA testing is used as one piece of the puzzle when looking at a male’s overall health.” PSA testing should not be a sole means of diagnosis or ruling out of any condition due to the many factors that can affect the level.
Patients who regularly take medications for high cholesterol, certain types of diuretics, medications designed to treat BPH, and aspirin all have been shown to have lower PSA levels. Obese patients also tend to have lower PSA levels. Because of this, using the PSA as a singular method of screening for prostate cancer and other conditions is highly unreliable and discouraged.
Please speak with your urologist here at Blue Ridge Urological if you would like more information about PSA testing and what it can mean for your health.