A Guide For Men Considering a PSA Test
The psa test is a simple blood test used to help detect prostate cancer. In its early stages, prostate cancer generally produces no symptoms, so it is important to diagnose the disease before symptoms arise and while it is still potentially curable. A recent trial suggests that treating prostate cancer may significantly prolong a man’s life. A high level of PSA
(usually 10ng/ml & above) is likely to be an indication of prostate cancer and should therefore prompt further investigation. A moderately raised PSA
level (usually 4ng/ml & above, dependant on age) means that other factors, including digital rectal examination, ethnicity family history, prostate volume, PSA history, and free to total PSA ratio, should be considered in determining whether to send a man for further tests such as biopsy.
However, in three quarters of such cases, further tests do not detect cancer. There can be other reasons for a moderately elevated PSA¸ e.g. urinary infection, enlarged prostate etc. and these may need treatment.Prostate cancer is not always aggressive or life threatening
. Even if further tests do detect early-stage prostate cancer, a specialist may not be able to tell whether the condition is life threatening or harmless. This may make treatment choices difficult for both patient & clinician.
All of these factors have led to the current controversy over the value of the PSA test, however, the uncertainties may be reduced by men having a regular test, ideally on an annual basis.
Regular monitoring of PSA levels can highlight any significant or gradual increase, so that even when the PSA is within the 'normal' range, one maybe alerted to the need for further investigation.