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The cells of men's prostate gland produce a protein called prostate-specific antigen, or PSA. Doctors perform PSA tests to determine the level of PSA in the blood. The PSA test is used to detect prostate cancer and benign (non-cancerous) conditions like prostatitis (an inflamed prostate) and benign prostatic hyperplasia (an enlarged prostate).
Most men have a low level of PSA in their blood. When a man has prostate cancer, prostatitis or BPH, his PSA level is usually increased. In fact, all prostate conditions become more common as men age.
A PSA test is an important tool that doctors use to detect prostate conditions in men. But since PSA tests cannot differentiate between cancerous and non-cancerous prostate conditions, it's only one tool doctors rely on to make the diagnosis.
Doctors use the PSA test to help detect prostate cancer in men aged 50 and older. Doctors also perform a digital rectal exam in tandem with the PSA test. The doctor inserts a gloved finger into the rectum and feels the prostate gland behind the rectal wall and checks for abnormalities. These tests are important, since prostate cancer usually has no symptoms.
Doctors also use the PSA test to determine if prostate cancer has returned.
It is recommended that all men 50 and older have an annual PSA test.
Men at risk for prostate cancer should start screening as early as age 40. Risk factors for prostate cancer include:
*Age-Being older than 65 increases your risk.
Family history-Men whose father or brother had prostate cancer are at increased risk.
Race-African American men have the highest prostate cancer rates.
Diet-Diets high in fat, particularly animal fat, have been linked to increased risk.
PSA test results are usually listed as nanograms of PSA per milliliter (ng/mL) of blood. Currently, there is no agreed-upon normal PSA level. But in the past, numbers below 4.0 ng/mL were considered normal.
In addition, it's important to remember that non-cancerous conditions like prostatitis can also cause a rise in PSA numbers. PSA levels also tend to rise with age. Therefore, one high PSA test does not necessarily mean you will require a prostate biopsy. Doctors take many factors into account when reviewing PSA numbers.
In the event that a man's PSA numbers are elevated and the DRE gives the doctor cause for concern, he will recommend a prostate biopsy to determine if cancer is present.
In the biopsy, the doctor removes a sample of tissue from the prostate. This is usually done with a needle. It can be done under either general or local anesthesia. The doctor may also perform an ultrasound so he or she can view the prostate during the biopsy.