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PSA (Prostate Specific Antigen) Total

Also known as PSA blood test

₹799

You need to provide

Blood

This test is for

Male

Test Preparation

It is advisable to avoid sexual intercourse, ejaculation, and vigorous exercise for up to 48 hours before sample collection.
Do not give sample within 7 days of Digital Rectal Examination (DRE) or Rectal Prostatic Ultrasonography.
Prostate biopsy causes a substantial elevation of the PSA levels. Talk to your doctor about the appropriate timing of the test.

Understanding PSA (Prostate Specific Antigen) Total

What is PSA (Prostate Specific Antigen) Total?

The PSA (Prostate Specific Antigen) Total test measures the total amount of PSA, a protein produced by the prostate gland that liquefies the semen in males. This test helps identify conditions like prostate inflammation (prostatitis), enlarged prostate (benign prostatic hyperplasia or BPH), prostate cancer, etc.

The prostate is a small walnut-shaped gland located just below the bladder and in front of the rectum in males. It produces a protein called PSA, mostly found in semen (also produced by the prostate gland) and helps in sperm motility during ejaculation in males. The PSA (Prostate Specific Antigen) Total test measures the total PSA level that includes the combined amount of free and bound PSA in the blood.

Your doctor may recommend the PSA (Prostate Specific Antigen) Total if you experience symptoms such as difficulty passing urine, straining or taking a long time while urinating, terminal dribbling, passing urine more frequently than usual, especially during the night, or blood in the urine. This test is also especially recommended in men over the age of 50 or at an earlier age (>40 years) for those at higher risk due to family history or other risk factors such as aging and high-fat diet.

Fasting is not required for this test; you may eat and drink as per your daily routine. However, talk to your doctor if you take any prescription or over-the-counter medications, as some may interfere with your test results. It is advised to avoid sexual intercourse for at least 48 hours before the test, as semen release (ejaculation) can increase your PSA levels, leading to inaccurate results. The PSA (Prostate Specific Antigen) Total should also not be done immediately after cystoscopy, digital rectal examination (DRE), prostatic massage, indwelling catheterization, ultrasonography, and prostate needle biopsy as they too may falsely elevate PSA levels.

A higher-than-normal total PSA level may indicate an enlarged (benign prostatic hyperplasia or BPH) or inflamed prostate (prostatitis), prostate cancer, urinary tract infection, irritation, or other problems like urethral or prostatic trauma. The PSA (Prostate Specific Antigen) Total also serves as a valuable tool to monitor disease progression, check for recurrence, and assess response to treatment in prostate cancer patients. Surgical castration or medical castration (using some drugs) can lower PSA levels dramatically. Therefore, a low PSA level after any such treatment that includes hormonal therapy may not adequately reflect the presence of residual or recurrent disease.

Talk to your doctor about your specific test results. Regardless of levels, PSA values are not absolute evidence of the presence or absence of disease. Further diagnostic tests, such as digital rectal examination (DRE) and biopsy, may be needed to confirm or rule out the possibility of cancer. However, some early cases of prostate cancer may not even be detected by PSA testing or DRE. Values obtained with different assay methodologies should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor the course of therapy.

What is PSA (Prostate Specific Antigen) Total used for?

The PSA (Prostate Specific Antigen) Total test is done:

If you have symptoms of any prostate condition such as painful or frequent urination, interrupted urine, blood in urine or semen, pelvic and/or back pain, or painful ejaculation.
To detect and diagnose diseases of the prostate gland, like benign prostatic hyperplasia (BPH) or prostatitis.
To screen for prostate cancer when used in conjunction with digital rectal exam (DRE), in men 50 years or older or to determine its extent. Testing should begin at a younger age in high-risk men (African-Americans) or those with first-degree relatives diagnosed at a younger age.
To monitor prostate cancer treatment.

What does PSA (Prostate Specific Antigen) Total measure?

The PSA (Prostate Specific Antigen) Total test measures the level of prostate-specific antigen (PSA) in the blood. PSA is a protein secreted by the prostate gland in males and is found in two forms: bound PSA (bound to other proteins) and free PSA. A PSA (Prostate Specific Antigen) Total test measures both free and bound PSA levels. Most of the PSA produced in the body passes in the seminal fluid and only a small amount is secreted into the blood.

PSA levels in the blood get elevated in conditions affecting prostate health, like prostate cancer, prostatitis, and prostate enlargement (benign prostatic enlargement or BPH). This test is used as a primary screening test along with DRE, before conducting other diagnostic procedures.

Interpreting PSA (Prostate Specific Antigen) Total results

Interpretations

The normal value of PSA in blood is below 4.0 ng/ml

A roughly 4.0 and 10.0 ng/ml PSA level is considered a “grey zone.”

Lower than 4.0 ng/ml PSA in blood indicates a very low risk for prostate cancer or BPH, while higher than 10.0 ng/ml indicates a very high risk of developing prostate cancer or BPH.

Different forms of PSA testing, as well as other tests, are recommended for further diagnosis.

Answers to Patient Concerns & Frequently Asked Questions (FAQs) about PSA (Prostate Specific Antigen) Total

Frequently Asked Questions about PSA (Prostate Specific Antigen) Total

Q. What is the full form of PSA?

The full form of PSA is prostate-specific antigen which is a protein produced by the cells of the prostate gland.

Q. What is the PSA Total test?

The PSA (Prostate-Specific Antigen) Total test is a blood test that measures the level of both free and bound forms of PSA protein which helps identify conditions such as prostate inflammation (prostatitis), enlarged prostate (benign prostatic hyperplasia or BPH), prostate cancer, etc. in males.

Q. What happens if the PSA level is high?

A higher PSA level indicates a higher risk of prostate-related problems, such as prostate enlargement, urinary tract infection, or prostate inflammation due to irritation, injury, or a surgical procedure. Consult a doctor or a urologist to understand your lab reports, and do not panic if your reports show high PSA levels. High levels of PSA do not necessarily indicate that you have prostate cancer. Your PSA may be elevated for other reasons, which can be managed with appropriate treatment.

Q. What are the symptoms of high PSA levels?

The symptoms associated with high PSA levels are difficulty in urination, painful or frequent urination (particularly at night), blood in urine or semen, weak or interrupted flow of urine, difficulty holding urine, painful ejaculation, and persistent pain in the lower back, pelvis, or thighs.

Q. What tests are done after reports show high PSA levels?

If your reports suggest high PSA levels, your doctor may prescribe additional tests before considering a prostate biopsy. These tests include digital rectal examination (DRE), free PSA test, PSA velocity test (indicating the rate at which PSA increases over time), PSA density test (indicating the PSA per volume of the prostate), PSA-based markers (like Prostate Health Index, 4K score), urinary markers, and magnetic resonance imaging (MRI) of the prostate.

Q. What factors can affect the results of the PSA test?

The PSA levels in the blood can be affected by several factors, including age, vigorous exercise or physical activities such as cycling in the last 2 days before testing, prostate gland size, prostate inflammation due to injury or infection (such as urinary tract infection or UTI), and ejaculation or sexual intercourse (anal sex or prostate stimulation) within 48 hrs of examination. Procedures like direct prostate examination, chemotherapy, prostate biopsy, cystoscopy (an endoscope is inserted through the urethra to examine the urinary bladder), and urinary catheter insertion may also affect your test results. Certain medicines, like finasteride, dutasteride, painkillers, etc., can also influence your test results.

Q. How can I reduce my PSA levels naturally?

Always consult your doctor if your test results show elevated PSA levels. However, you can make lifestyle changes to reduce your PSA levels naturally. These include eating more proteins, tomatoes, and cruciferous vegetables; maintaining adequate vitamin D levels in your body; exercising regularly to maintain a healthy weight; and managing your stress, as high stress may be associated with elevated PSA levels.

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