PSA (Prostate Specific Antigen) Total
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.