What Is PSA?

prostate cancerProstate Specific Antigen is a protein that is only produced by the prostate gland. The PSA test measures the amount of PSA in an individual’s blood.

What Diseases/Conditions is PSA Linked To?

An elevated level of PSA in the blood may indicate prostate cancer. In addition to prostate cancer, other conditions can cause a PSA level to rise, including prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (enlargement of the prostate).

Symptoms of High Levels of PSA

There may be no symptoms when high levels of PSA are present. However, high levels of PSA can be caused by prostate cancer which may have symptoms such as:

  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in the semen
  • Discomfort in the pelvic area
  • Bone pain
  • Erectile dysfunction

What is a Normal Level of PSA?

As is the case with PSA screening, there is also no agreement in the medical community about what constitutes a normal PSA level. However, most doctors consider 4.0 ng/mL and lower to be a normal level of PSA. In general, the higher the PSA level, the more likely prostate cancer exists. Perhaps even more importantly, a continuous rise in a PSA levels over time may also be a sign of prostate cancer. However, a normal PSA level does not rule out the possibility of prostate cancer. A traditional manual screening performed by a medical professional is strongly encouraged.

Who May Want to Have Their PSA Level Tested?

There is quite a debate about who should get the PSA test, and medical organizations differ on their recommendations. Individuals are encouraged to consider their risk factors and speak with their health care provider to make the decision about getting screened for PSA. Some medical providers recommend screening beginning at age 50 for individuals with a prostate that have no risk factors.

As of April 2017, the United States Preventive Services Task Forces is reviewing its guidelines for PSA screening and is recommending consideration for PSA testing for individuals with a prostate 55-69 years of age based on their family history, race, etc.  They continue to recommend against screening in individuals with a prostate over 70.

Risk Factors to Consider:

  • Age – Your risk of prostate cancer increases as you age. Currently, Medicare provides PSA coverage for persons with a prostate that are 50 and older and Medicare eligible. Many private insurers cover PSA screening as well.
  • Race –  African-Americans have a greater risk of prostate cancer than other races. Prostate cancer is also more likely to be aggressive or advanced in African Americans, though it’s not clear why this is.
  • Family history of prostate or breast cancer. If people in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher.
  • Obese individuals diagnosed with prostate cancer may be more likely to have advanced disease that’s more difficult to treat.

Always seek the advice of your doctor if you have questions about your results.