What is a PSA Test?

by Dr. Jay Molota

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 and malignant, can result in an elevation of the PSA.

What Causes a Change in PSA Level?

Although prostate cancer is the most serious abnormality that is associated with an elevation of the PSA, other common conditions can also cause a rise in PSA level.  These conditions include benign prostatic hyperplasia or BPH (enlarged prostate), infections or inflammatory conditions of the prostate (prostatitis), urinary tract infections and prostatic stones.  Even in healthy men, PSA is known to rise with increasing age and prostate size. Engaging in sexual activity just prior to undergoing a PSA test may also be associated with an elevation of the PSA.  The amount of elevation of the PSA, the patient’s age, clinical symptoms or lack of them, and the examination of the prostate all play a role in the examining physicians decision to either

a)      Recommend a treatment that may help lower the PSA by treating the underlying condition that is leading to the elevation; or

b)      Perform a biopsy of the prostate that would definitively establish if prostate cancer is the source of the PSA elevation.

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