PROSTATE-SPECIFIC ANTIGEN (PSA) TESTING FOR PROSTATE CANCER

Prostate cancer begins in the prostate.  The prostate is a walnut-sized gland located inside the body underneath the bladder.  Its main function is to make seminal fluid, the liquid in semen that protects, supports, and helps transport sperm.

Prostate cancer grows slowly in many men, so slowly that in some men it would not threaten their life, even if not treated.  However, in some men, prostate cancer can grow quickly and may spread to other parts of the body.  In these situations, a man’s prognosis (chance of recovery) may be better if these faster-growing, more dangerous cancers are found earlier, when treatment is more effective.  This has been the goal for using PSA testing to screen men with no symptoms of prostate cancer.

PSA is a substance in the blood that is primarily made by the prostate gland.  It can be found in higher-than-normal levels in men with various prostate conditions, including prostate cancer, benign (noncancerous) prostatic hyperplasia (BPH, an enlarged prostate), and inflammation or infection of the prostate.

There is controversy about using the PSA test to look for prostate cancer in men with no symptoms of the disease.  Although the PSA test has been shown to lower death rates from prostate cancer by finding prostate cancer earlier, it also has been linked to higher instances of unnecessary treatments.

Recommendations for PSA Testing
For men expected to live 10 years or less, general screening is not recommended because the risks appear to outweigh the benefits for most men and for men expected to live longer than 10 years, patients should talk about PSA testing with their doctors to find out if it is an appropriate test for them.

Questions to Ask Your Doctor

• How is my health in general?
• What is my risk of developing prostate cancer? How is it determined?
• Is PSA testing appropriate for me? If so, at what age should testing begin?
• What is the purpose of a PSA test?
• What issues should I consider before making my decision?
• What are some reasons I wouldn’t get a PSA test?
• If I choose PSA testing, what are the next steps if I have a raised PSA level? How often should I be screened?
• Are there other tests to help find prostate cancer early?
• Factors that might affect PSA levels

Before considering PSA testing, it’s important to talk with your doctor about your individual risk of developing prostate cancer, as well as the risks and benefits of PSA testing.  In some situations, PSA testing finds aggressive prostate cancers early and save lives.