Elevated PSA level is an indicator of problems with the prostate gland.
Prostate specific antigen (PSA) is a glycoprotein produced by normal prostate tissue and is measured by obtaining a blood sample. Several conditions cause an elevation in PSA, the most important being prostate cancer. Other non-cancerous conditions causing an increase in PSA include BPH (benign prostate hyperplasia), prostatitis (prostate infection), urinary retention (inability to urinate completely), as well as perineal trauma (body region where prostate is located). Men are usually offered an initial PSA test (PSA screening) at age 50 and PSA testing is done yearly thereafter.
In men with a high risk of developing prostate cancer (family history of prostate cancer), screening is usually offered at age 40.
Symptoms of Elevated PSA
If an elevated PSA is due to a prostate infection or BPH, symptoms commonly experienced may include painful, frequent, and urgent urination as well as a slow urinary stream. However, one may not have any symptoms at all. Prostate cancer causing an elevation in PSA may or may not be associated with the above urinary symptoms.
Evaluation and Treatment of Elevated PSA
Men with an elevated PSA should undergo a thorough evaluation by a urologist. A history and physical examination are usually the first steps employed in the evaluation. Because PSA can be elevated in a variety conditions, efforts have been made to use the test in combination with other factors to make the test more accurate in “predicting” one’s risk of prostate cancer. These include “free” as well as “total” PSA, “PSA density”, and “PSA velocity”.
There are established reference ranges for PSA based on the age of the individual.
In men suspected of having prostate cancer based on their PSA level, prostate exam, or both, a prostate biopsy is offered. This procedure is done in the office under a local anesthetic (prostate nerve block) which has dramatically improved the tolerability of this procedure.