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Prostate-Specific Antigen (PSA) Test

  • Definition

    Prostate specific antigen (PSA) is a protein made by the prostate. Prostate is a walnut-sized gland in men that makes a fluid for semen.
    Most PSA is released into semen. Some of it is released into the blood. If there is a problem with the prostate, the PSA level in the blood can become elevated.
    Anatomy of the Prostate
    Anatomy of the Prostate Gland
    Copyright © Nucleus Medical Media, Inc.
  • Reasons for Test

    The PSA test is used to:
    • Monitor treatment effectiveness for prostate cancer
    • Help determine if cancer has returned in men who have already been treated for prostate cancer
    • Test for other conditions, like prostatitis , or benign prostatic hyperplasia
    The PSA test may also be used as a screening tool for prostate cancer . However, this use is controversial. Talk to your doctor about the risks and benefits of the PSA test, and your personal risk factors for prostate cancer.
  • Possible Complications

    There are no major complications associated with this test.
  • What to Expect

    Prior to Test
    • Ejaculation can cause PSA levels to rise. Avoid sexual activity for 24 hours before testing.
    • Some procedures can elevate PSA levels. Schedule your PSA test several weeks after any of these:
    • Wait several weeks after successful treatment of prostate infections.
    • Some medicines can lower PSA levels. Tell your doctor if you are taking:
      • Finasteride
      • Dutasteride
    Description of Test
    You will be asked to sit. An area inside your elbow will be cleaned with an antiseptic wipe. A large band will be tied around your arm. The needle will then be inserted into a vein. A tube will collect the blood from the needle. The band on your arm will be removed. Once all the blood is collected, the needle will be removed. Some gauze will be placed over the site to help stop bleeding. You may also be given a bandage to place over the site.
    After Test
    After the blood sample is collected, you may need to stay seated for 10-15 minutes. If you are lightheaded, you may need to stay seated longer. Once you feel better, you can leave.
    How Long Will It Take?
    The process takes about 5-10 minutes.
    Will It Hurt?
    It may be uncomfortable when the needle pierces your skin.
    Results
    The results are usually available in a few days to a week. Your doctor will talk to you about your results.
    If your PSA level is slightly elevated, but there are no other reasons to suspect prostate cancer, your doctor may recommend closely following your PSA levels.
    If your PSA level is too high, has risen significantly, or the doctor notices a lump during a digital rectal exam, you will probably need to schedule other tests, such as a prostate biopsy.
  • Call Your Doctor

    After the test, call your doctor if any of the following occurs:
    • Bleeding from the puncture site
    • Red, swollen, or painful puncture site
    • If you have not heard from your doctor in 1-2 weeks
  • RESOURCES

    American Cancer Society http://www.cancer.org

    Urology Care Foundation http://www.urologyhealth.org

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca

    Prostate Cancer Canada http://www.prostatecancer.ca

    References

    Fang J, Metter EJ, et al. PSA velocity for assessing prostate cancer risk in men with PSA levels between 2.0 and 4.0 ng/mL. Urology. 2002;59:889-893.

    How did the USPSTF arrive at this recommendation? US Preventative Services Task Force website. Available at: http://www.uspreventiveservicestaskforce.org/prostatecancerscreening/prostatecancerfaq.htm. Published May 2012. Accessed September 12, 2012.

    Members of the Prostate-Specific Antigen Best Practice Statement Panel (2009). Prostate-Specific Antigen Best Practice Statement: 2009 Update. Available at: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf. Accessed April 17, 2013.

    Prostate cancer screening. EBSCO DynaMed website. http://www.ebscohost.com/dynamed. Updated March 15, 2013. Accessed April 17, 2013.

    Prostate-Specific Antigen (PSA) Test. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Detection/PSA. Updated July 24, 2012. Accessed April 17, 2013.

    Screening for prostate cancer: current recommendation. US Preventative Services Task Force website. Available at: http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm. Published May 2012. Accessed April 17, 2013.

    Stephan C, Stroebel G, et al. The ratio of prostate-specific antigen (PSA) to prostate volume (PSA density) as a parameter to improve the detection of prostate carcinoma in PSA values in the range of < 4 ng/mL. Cancer. 2005;104:993-1003.

    5/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Schröder FH, Hugosson J, Roobol MJ, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360:1320-1328.

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