What Does PSA Mean? PSA is a blood test that is commonly used to help predict the presence of prostate cancer . It stands for Prostate Specific Antigen (PSA) and refers to a protein first identified in 1979 that is made only by the prostate gland. It is currently used as a tumor marker and can also help monitor disease progression or lack of recurrent disease in patients who have previously undergone treatment for prostate cancer . A tremendous amount of confusion exists amongst patients and the popular press regarding PSA. Part of this lack of understanding has occurred because many think that an elevation in the PSA level means that one definitely has prostate cancer. In actuality, this is not true and this article should help clarify some of the confusion surrounding PSA testing. Most important is the “S” in PSA, which refers to the protein being specific to the prostate gland and not specific to cancer. Many conditions, both benign ...
Dear Dr. Greenstein:
My friend ,who is in his early 50s, just got the results of his annual PSA test - it was between 4-5. The results of his previous 6 annual tests were in the 1-2 range every year, until now. His brother recently had his prostate removed due to cancer.
He now has to see a specialist. We are both very concerned, but should we be that worried?
First, I never tell people to worry before we have all the answers. In this situation, it is crucial to know if this man has any new voiding problems such as burning, slow stream or the sensation he is not emptying his bladder. These symptoms can indicate prostate inflammation, which can falsely elevate the PSA value. In those cases, a course of antibiotics are warranted and the PSA can be repeated after finishing the antibiotics.
If the PSA normalizes then this man can continue to have his prostate examined every 6 - 12 months. The physical exam is also very important. The discovery o...
A 62-year-old patient had surgery to remove his cancerous prostate gland about 6 years ago. Two years after surgery his PSA started to rise and now his PSA is 4.6 ng/ml.
I hate to say it but, it is clear that this patient has failed surgery and has "biochemical failure." In other words, his prostate was removed but there is something in his body making his PSA go up and probably more cancerous cells in his body. Even though he feels fine, this rise in PSA is the only sign that his prostate cancer is trying to return. There are two places were cancer can return: 1) in the pelvis where the prostate used to be located, or 2) elsewhere in the body, suggesting that the cancer has spread. Unfortunately, this is a fairly common problem. Up to 30% of men will not be cured by surgery alone and they will have a rise in their PSA months or years after the prostate is removed. That is why it is crucial for men to have their PSA checked on a regular basis after treatment.
There are f...
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