The amount of 'Prostate Specific Antigen' (PSA) in blood is normally very small. A simple blood test informs about the amount of PSA in blood. It is recommended that men over 50 should get their PSA levels checked every year. PSA test helps diagnose prostate cancer. High PSA levels indicate increased risk for prostate cancer, but they do not confirm prostate cancer. Those who have been diagnosed with prostate cancer need to undergo PSA test regularly; as it helps monitor the effect of the treatment. PSA numbers provide information on the health of the prostate gland.
Normal Blood PSA
The normal PSA level may vary from person to person but majority of labs consider PSA less than 4 ng/mL (nanograms per milliliter of blood) as normal levels. Elevated levels of PSA indicate increased risk of cancer. To detect prostate cancer at a very early stage, some labs consider PSA less than 2.5 ng/mL or 3 ng/mL, as the normal level of PSA. To avoid over diagnosis and unnecessary treatment for the condition which may never cause any problem in future, it is suggested that PSA level less than 4 ng/mL should be considered as normal PSA level. PSA test results need to be interpreted very carefully.
Elevated Levels of PSA
|PSA Test Numbers||Interpretation|
|Less than 4 ng/mL||Normal|
|4 - 10 ng/mL||20 - 30% risk of cancer|
|10 - 20 ng/mL||50 - 75% risk of cancer|
|Above 20 ng/mL||90% risk of cancer|
Though the table illustrates the relationship between high PSA levels and prostate cancer, some benign conditions like 'Benign Prostatic Hyperplasia' (BPH) or 'enlarged prostate' can raise the levels of PSA. An infection can lead to inflammation of the prostate gland, resulting in higher than normal PSA in blood. Such condition is known as prostatitis. So, to know the exact cause behind elevated prostate levels, your doctor might order another test 'digital rectal exam' or DRE. The doctor might also ask you to undergo a repeat PSA test after a few days. Recently performed DRE or prostate biopsy can lead to higher than normal PSA levels. Doctors will therefore examine PSA test numbers once again, check the symptoms cautiously; and will then arrive at the final conclusion.
Aging also leads to high PSA levels. Enlarged prostate is a common problem in elderly. Statistics show that genetics play an important role in prostate health. American men of African origin are more prone to prostate cancer. Studies suggest that taller men, men who lead a sedentary lifestyle, men who have sex more than 20 times a month, men who have to face poor and grim weather (very low temperature and lack of sun) or men who live in areas which have more night-time illumination, men who work in certain industries like rubber, certain workers like welders are more likely to develop prostate cancer. Such men should undergo a PSA test regularly after 40.
Chemotherapy, radiation therapy and prostate surgery are the ways to treat prostate cancer. If prostate is removed surgically, then PSA count should come down to zero. Cancer patients need to check PSA levels regularly after surgery. If PSA is present in blood after prostate removal surgery, then it suggests recurrence of cancer.
Those who have slightly elevated PSA levels, are often advised to wait and watch. Treatment is deliberately delayed. These people are asked to undergo PSA test at regular intervals. Certain medicines, even ejaculation and cycling can lead to increased PSA levels. Doctors take into consideration free PSA, PSA density, PSA velocity, DRE and biopsy results, and then confirm the diagnosis of prostate cancer. Having higher than normal PSA does not mean that you have prostate cancer.