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Prostate specific antigen (PSA) is a glycoprotein produced in the prostate gland in men, an enzyme – serine protease. It liquefies the sperm. The antigen test is used to diagnose and track the course of prostate cancer, but also to detect benign prostatic hyperplasia.
What is prostate specific antigen (PSA)?
PSA, or prostatic antigen, is a glycoprotein produced by the cells of the prostate glandular epithelium. The examination of the specific antigen of the prostate is used not only to detect but also to treat prostate cancer. The PSA test often detects the disease at an early stage of development, making treatment more effective.
It should also be remembered that the PSA antigen is also produced by the healthy epithelium in the prostate area and can also be detected in people with a healthy gland, in gland inflammation and in people with prostate cancer. A patient’s venous blood sample is required to perform the test.
The PSA test result should always be interpreted by a specialist.
When do we do the PSA test?
The PSA test is especially recommended for men over 40. Regular examination of the prostate gland is important (at least once a year) – in the event of any abnormalities, PSA levels can be tested. Also people with a family history of prostate cancer should go to such an examination. Remember that prostate cancer is often asymptomatic. However, men should make an urological appointment immediately after noticing the following symptoms.
- blood in sperm
- erectile dysfunction,
- lower abdominal pain,
- burning sensation when urinating,
- bleeding when urinating
- trouble keeping urine.
Do you want to measure PSA levels, as well as other parameters such as testosterone, uric acid or creatinine? We recommend the e-packet for men. The price also includes consultation with a doctor or diagnostician.
Other indications for a PSA test
- Suspicion of prostate gland pathology (inflammation, benign hyperplasia, cancer) in cases of difficult, painful and frequent urination.
- Monitoring the treatment of prostate cancer.
- Screening for men over 50.
- The presence of changes in the prostate during palpation.
PSA test – course
In the human body, specific prostate antigen exists in free and protein-bound form. Both of these values make up the score total PSAwhich is the basis. When the total PSA result is outside the norm, the total PSA and its free fraction are tested. This ratio has a greater sensitivity, so that the result is more accurate. Testing for specific prostate antigen is free of charge if you have a referral from a doctor. Performing the marking privately costs PLN 30-60.
Currently, the PSA test can be performed independently at home, thanks to a special test available at the pharmacy. Home PSA test it only determines whether the antigen level is elevated or normal. A home test does not show specific blood PSA values. Therefore, a blood test performed in a laboratory is more reliable.
Material for testing the PSA antigen: serum.
Preparation for the test: fasting is not necessary and blood can be drawn at any time of the day. For the reliability of the results, it is good to keep a pause between the prostate palpation, exercise, biopsy and blood sampling. In addition, two days before the PSA test, a man should give up sexual activity.
The course of the PSA test: one-time blood sampling from a vein in the arm.
Time to wait for the result: 1 Day.
The norm of the total PSA is:
- between 40 and 49 years of age up to 2,5 ng / ml,
- between 50 and 59 years of age up to 3,5 ng / ml,
- between 60 and 69 years of age up to 4,5 ng / ml,
- between 70 and 79 years of age to 6,5 ng / ml.
When the total PSA result is between 4 and 10 ng / ml, the prostate free antigen fraction is tested.
Comments: Increased PSA levels have been observed in people taking drugs used to treat heart rhythm disorders and to treat high blood pressure. The concentration of PSA also increases with the increase in the mass of the neoplastic tissue. Therefore, the determination of PSA levels is also used to monitor the effectiveness of prostate cancer treatment. With its help, it is also possible to detect the recurrence of the neoplastic process.
However, PSA concentration also increases after palpation of the prostate gland and after prostate biopsy. Therefore, a PSA determination should be performed prior to these procedures.
In the event of an abnormal PSA concentration, the diagnosis is extended to include transrectal ultrasound and prostate biopsy.
Check: Transrectal ultrasound – indications, preparation, course
PSA antigen – interpretation of results
An increased PSA result does not always mean that the patient has 100% prostate cancer. Sometimes the result may be falsely elevatedespecially when tested:
- suffers from benign prostatic hyperplasia,
- two days before the examination, he ejaculated,
- two days before the examination, he was engaged in intense physical activity,
- shortly before the blood test, he underwent a rectal examination,
- a few days before blood sampling, he had a prostate biopsy,
- two days before the examination, he had an ultrasound of the prostate,
- has inflammation of the prostate or urinary tract,
- takes drugs used in oncological treatment,
- is after surgery to remove a fragment of the prostate (within six weeks before the PSA test).
While a false low PSA result refers to:
- testicular removal surgery,
- complete prostate removal,
- chemotherapy and radiation therapy.
Sometimes the opposite situation is also observed, i.e. in men, despite the correct PSA result, the disease develops.
If the test shows an increase in total PSA, it should be performed free PSA prostate antigen concentration test. Determining this ratio is useful in deciding whether to follow up or perform a biopsy. The analysis of free PSA in relation to the increased level of total PSA is as follows:
- low PSA free – indicates an increased risk of prostate cancer
- high PSA free – indicates a low risk of malignant neoplasm of the prostate.
A high concentration of specific PSA prostate antigen above 10 ng / ml and an increase in the antigen concentration in a short time (regardless of age) indicate a high risk of developing prostate cancer. Only prostate biopsy can confirm or rule out prostate cancer.
Other prostate cancer biomarkers
The PSA antigen is a fundamental and extremely important indicator of the health of the prostate. However, if a patient is diagnosed with prostate cancer, other tests may also be performed. Based on the blood test, biomarker analysis can be performed, which provide useful information about the advancement of the disease or the progress of treatment. Examples of such indicators are:
- CTC – circulating tumor cells are important for the assessment of the risk of metastasis as well as the effectiveness of the treatment;
- kallikreins – indicate the advancement of the disease;
- UPA – urokinase plasminogen activator serves to monitor the patient’s health, including detecting disease relapses or metastases;
- TGF beta-1 – it is a growth factor whose overexpression informs about a higher risk of metastasis and the degree of prostate tumor development;
- interleukin 6 – also may indicate the presence of metastases.
It is also worth mentioning the possibility of research urinary cancer biomarkers (including delta-catenin, annexin 3, hepatocyte growth factor) and intracellular biomarkers (e.g. PSMA, Ki-67, cytocreatine). Continuous development in the field of molecular research opens up wider possibilities for conducting treatment of prostate cancer. Additional tests allow for a better adjustment of the treatment, assessment of the following changes and the patient’s prognosis.
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