Prostate Specific Antigen (PSA)

Serum
Optimal Result: 0 - 4 ng/mL.

Prostate-specific antigen (PSA) is one of the proteins that the prostate gland makes. Cancerous cells of the prostate also create these proteins. The purpose of the PSA test is to identify that the prostate gland is stressed and may have significant disease. 

High PSA levels are not necessarily correlated with cancer. They may mean that there is a urinary tract infection or the prostate is simply inflamed.  According to the National Cancer Institute, “there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men in any racial or ethnic group.”

What is a normal PSA test result?

There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.

However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer.

In addition, various factors can cause a man’s PSA level to fluctuate. For example, a man’s PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugs—including finasteride and dutasteride, which are used to treat BPH—lower a man’s PSA level. PSA level may also vary somewhat across testing laboratories.

Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of white men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.

In general, however, the higher a man’s PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a man’s PSA level over time may also be a sign of prostate cancer.

Sources:

  1. http://www.lifeextension.com/magazine/2006/5/report_blood/Page-02
  2. https://www.cancer.gov/types/prostate/psa-fact-sheet
  3. https://www.mayoclinic.org/tests-procedures/psa-test/about/pac-20384731
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850026/

What does it mean if your Prostate Specific Antigen (PSA) result is too high?

Elevated Prostate-Specific Antigen (PSA) levels can be an indicator of prostate issues, including prostate cancer, benign prostatic hyperplasia (BPH), or prostatitis. PSA is a protein produced by both normal and malignant cells of the prostate gland, and its levels are measured through a simple blood test.

The diagnosis of prostate conditions, especially prostate cancer, often begins with the detection of elevated PSA levels. However, it's crucial to understand that elevated PSA does not definitively indicate cancer. Many factors, such as age, race, and prostate size, can influence PSA levels. Additionally, certain activities, including sexual activity or a recent prostate examination, might temporarily raise PSA levels.

Symptoms that might prompt a PSA test include difficulty in urinating, frequent urination, painful or burning sensation during urination or ejaculation, blood in urine or semen, and chronic pain in the lower back, hips, or thighs. However, these symptoms can also be related to non-cancerous conditions.

If a PSA test is elevated, doctors might recommend further testing to determine the cause. This can include a repeat PSA test, digital rectal exams (DRE), prostate biopsies, or imaging tests like MRI or a CT scan.

Treatment options vary depending on the underlying cause of the elevated PSA. For prostate cancer, options may include active surveillance (monitoring), surgery, radiation therapy, hormone therapy, chemotherapy, or a combination of these. In cases of BPH, treatment might involve medication, lifestyle changes, or minimally invasive therapies. Prostatitis, which is often caused by a bacterial infection, might be treated with antibiotics.

It's essential for individuals with elevated PSA levels to have detailed discussions with their healthcare providers. The choice of treatment should be based on individual risk factors, the severity of symptoms, the stage of the disease, and overall health. Additionally, the potential benefits and risks of each treatment option should be carefully considered.

For the most accurate diagnosis and treatment plan, consulting with a healthcare professional who specializes in urology or oncology is recommended. They can provide personalized advice based on the individual's specific health situation.

Here are a few videos on prostate cancer and diet:

Changing a Man’s Diet After a Prostate Cancer Diagnosis

- Best Supplements for Prostate Cancer

Treating Advanced Prostate Cancer with Diet: Part 1

Treating Advanced Prostate Cancer with Diet: Part 2

Treating Prostate Cancer with Green Tea

Some clinical trials and studies have suggested that lycopene might decrease PSA levels.

Lycopene is a naturally occurring chemical that gives fruits and vegetables their red color. It is a type of carotenoid, which are pigments produced by plants, algae, and several bacteria and fungi. Lycopene is found in high concentrations in tomatoes, but it is also present in other red fruits and vegetables such as watermelons, pink grapefruits, apricots, and pink guavas.

In the human body, lycopene acts as an antioxidant. Antioxidants are substances that can prevent or slow damage to cells caused by free radicals, which are unstable molecules that the body produces as a reaction to environmental and other pressures. The damage caused by free radicals has been linked to various chronic diseases, including cancer and heart disease.

What does it mean if your Prostate Specific Antigen (PSA) result is too low?

Low levels of PSA are not a health problem. 

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