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  • Prostate-Specific Antigen (PSA) Test

    Definition

    Prostate-specific antigen (PSA) is a protein made by the prostate gland. The prostate is a gland in men. It makes fluid found in semen. The gland is located near the bladder and rectum.
    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
    The PSA test may also be used as a screening tool for prostate cancer. However, this use is controversial. Organizations like the United States Preventative Services Task Force (USPSTF) recommend against using the PSA test. It has found that screening tests may result in unnecessary surgery. Talk to your doctor about the risks and benefits of the PSA test, and your personal risk factors for prostate cancer.
    An elevated PSA level may also indicate other conditions, such as:

    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 2-3 days 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 (such as Propecia or Proscar)
      • Dutasteride (such as Avodart)

    Description of Test

    Blood needs to be drawn for this test. An elastic band will be wrapped around your upper arm. An area on your arm will be cleaned with alcohol. The needle will then be inserted into your arm. A small amount of blood will be drawn into a tube. The needle will be removed. Pressure will be applied to the puncture site. A small bandage may be placed on the site. Your blood will be sent to a lab for testing.

    After Test

    You will be able to leave after the test is done.

    How Long Will It Take?

    Drawing blood takes only a few 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

    Cancer facts: questions and answers about the prostate-specific antigen (PSA) test. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Detection/PSA. Updated July 2012. Accessed September 12, 2012.

    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 September 12, 2012.

    Screening for prostate cancer: current recommendation. US Preventative Services Task Force website. Available at: http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm. Published May 2012. Accessed July 27, 2012.

    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.

    Thompson IM, Ankerst DP, et al. Operating characteristics of prostate-specific antigen in men with an initial PSA level of 3.0 ng/ml or lower. JAMA. 2005;294:66.

    5/6/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: 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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