interpreting psa results - mercy health foundation

A Catholic healthcare ministry serving Ohio and Kentucky

Understanding the PSA Test and its Results

Prostate-specificantigen,orPSA,isaproteinproducedbynormal,aswellasmalignant,cellsoftheprostategland.ThePSAtestmeasuresthelevelofPSAinaman’sblood.Forthistest,abloodsampleissenttoalaboratoryforanalysis.TheresultsareusuallyreportedasnanogramsofPSApermilliliter(ng/mL)ofblood.

WhatisanormalPSAtestresult?ThereisnospecificnormalorabnormalPSAlevelintheblood,andmanylevelsmayvaryovertimeinthesameman.MostdoctorsusuallyconsiderPSAlevelsof4.0ng/mLandlowerasnormal.However,recentstudieshaveshownthatsomemenwithPSAlevelsbelow4.0haveprostatecancer,andmanymenwithhigherlevelsdonothaveprostatecancer.ThemostimportantfactorisroutinePSAinvolvementandseeinghowlevelschangeeachyear.

WhattodoifelevatedPSAResult?• Ifamanwhohasnosymptomsofprostatecancergets

screenedandhasanelevatedPSA,anothertestmayberecommendedtoconfirmtheoriginalfinding

• Ifaman’sPSAlevelcontinuestoriseorifasuspiciouslumpisdetectedduringaDRE,thephysicianmayrecommendadditionalteststodeterminethenatureoftheproblem

• Ifprostatecancerissuspected,thedoctorwillrecommendaprostatebiopsy.Duringthisprocedure,multiplesamplesofprostatetissuearecollectedbyinsertinghollowneedlesintotheprostateandthenwithdrawingthem.

• ElevatedPSAlevelscanalsobecausedbymedicalprocedures,BPH,recentsexualintercourse,orprostateinflammation/infection

Limitationsandpotentialharms

ManytumorsfoundthroughPSAtestinggrowsoslowlythattheyareunlikelytothreatenaman’slife.Twocommonpotentialharmsexistinthiscase:• Overdiagnosis-Detecting

tumorsthatarenotlifethreatening,whichleadtounnecessarytreatment.

• Overtreatment-Treatingthesetumorsthatarenon-lifethreatening.ActiveSurveillanceisaviableoptionforsmall,low-risktumors.Overtreatmentexposesmenunnecessarilytothepotentialcomplicationsandharmfulsideeffectsoftreatmentsforearlyprostatecancer,includingsurgeryandradiationtherapy.