But PSA results aren’t always reliable, and sometimes doctors aren’t sure what they mean. PSA is a protein made only by the prostate gland. A Digital Rectal Examination (DRE) is when a specialist inserts a gloved finger into your rectum to feel the back of the prostate to check for enlargement of the prostate gland or any other changes in shape. Biopsies miss 1 in 5 prostate cancers and can sometimes cause complications. This involves taking small samples of your prostate and checking them for cancer. These false-positives are common. Detection. PSA testing can also lead to the ‘over-diagnosis’ of some cancers that might never have caused problems and would not have otherwise been diagnosed if there were no symptoms. Any additional screening tests requested within this period is privately billed. A high PSA can cause a lot of worry and lead to more tests. It is therefore advised that readers seek the services and advice from their GP (doctor) or urologist for any personal health concerns. The information provided in this article is for education purposes only. [1-4] Read this Pathology Fact Sheet for more information. It aims to give men good information on the pros and cons of a PSA test. In some cases, your doctor may also suggest a Magnetic Resonance Imaging (MRI) scan of the prostate to help locate specific areas in the prostate that may be cancerous. The tissue samples are then sent to a pathologist to see if cancer cells are present. Blood levels of PSA can be elevated in men with prostate cancer. RACGP guidelines recommend that tests should not be taken within 24 hours of ejaculation or after vigorous physical activities such as bike riding. Men who are 55 to 69 years old should make individual decisions about being screened for prostate cancer with a prostate specific antigen (PSA) test. Should I have the PSA test? If you have a raised PSA level, you may need other tests, such as a biopsy. This is a simple blood test that measures the presence of PSA circulating in your bloodstream. PSA is prostate specific antigen, a protein made by prostate cells that shows up in your blood with a PSA blood test. Levels between 4.0 µg/L and 10.0 µg/L may indicate non-cancerous conditions (e.g. If you have prostate cancer, your specialist will discuss your options with you. Prostate Specific Antigen (PSA) Test for Prostate Cancer, no government-sponsored prostate screening, Navigate Trial featured on Channel 7 ‘House of Wellness”, Overcoming Prostate Cancer: A survivor & his wife tell their story | Prostate cancer nurse expert advice | Podcast Interview Part 1, Overcoming Prostate Cancer: A survivor & his wife tell their story | Prostate cancer nurse expert advice | Podcast Interview Part 2, What is low-risk prostate cancer? But when they are found, they often get treated with surgery to remove the prostate or with radiation. A PSA test can show if you have normal or high amounts of PSA … PSA 1.0 is lower than men limit of PSA but is still not a cancer marker. All men over the age of 40 should have a PSA blood test and digital rectal exam as part of their annual physical. If you're aged 50 to 69, raised PSA is 3ng/ml or higher. The PSA test is a blood test that can detect the early signs of an enlarged prostate. Therefore, high levels of PSA in the blood can be an indicator of prostate cancer. Navigate Trial features in Department of Veterans’ Affairs Newspaper 2020, Coronavirus Pandemic: Concerns over reduction in vital cancer screening and testing numbers, Coronavirus Pandemic: Alarming 60% decline in crucial prostate cancer testing. If you are at higher risk of developing prostate cancer, or if you have symptoms that may indicate cancer, PSA testing may be of more benefit. "Since it takes about two to three days for PSA to go down by half, you should wait two to three weeks after this type of trauma to do a PSA test," Milner says. A high PSA result can be due to a variety of reasons including non-cancerous prostate conditions: Benign Prostatic Hypertrophy (BPH): enlargement of the prostateProstatitis: swelling of the prostate due to infectionUrinary Tract Infection (UTI), Vigorous exercise and bike ridingRecent sexual activityCertain medications A recent pelvic injury Medical treatment such as a prostate biopsy, examination or surgery. Side effects of some treatments can include problems with erections, loss of fertility and incontinence. All rights reserved. Schedule a PSA test if you have a urinary tract infection. The PSA test is a blood test to help detect prostate cancer. Close menu. If you are healthy, aged 50-69 years with no signs or symptoms, and have no family history of prostate cancer; your GP may not necessarily screen you for prostate cancer or ask you to have the PSA test. A prostate biopsy may be recommended if there is an elevated PSA or a rapid rise in PSA. A PSA blood test is used to determine the levels of PSA in the male blood. Medicare will pay for one test per patient per year. For men aged 70 and older, the risks of PSA testing may outweigh the benefits. It is the most common initial test for men who are worried about prostate cancer. A ‘normal’ PSA level is dependent on age and typically increases as men get older since the prostate becomes enlarged with age. Next review due: 12 June 2021, it may reassure you if the test result is normal, it can find early signs of cancer, meaning you can get treated early, PSA testing may reduce your risk of dying if you do have cancer, it can miss cancer and provide false reassurance, it may lead to unnecessary worry and medical tests when there's no cancer, it cannot tell the difference between slow-growing and fast-growing cancers, it may make you worry by finding a slow-growing cancer that may never cause any problems. no symptoms) male is entitled to one PSA screening test within a 12 month period. A GP may also perform a digital rectal examination (DRE) to feel for any changes to your prostate gland. Do I need the PSA test? A high PSA level does not generally mean that a man should have a prostate biopsy. A raised PSA level in your blood may be a sign of prostate cancer, but it can also be a sign of another condition that's not cancer, such as: About 3 in 4 men with a raised PSA level will not have cancer. Age should play no part in this new screening, but rather sexual activity history, and anyone who has had a positive cervical HPV test (and treatment) should certainly NOT be left for another 5 years before re-checking. However, you can still request to be tested. There's currently no national screening programme for prostate cancer in the UK because the PSA test is not always accurate. Many cancers found by PSA tests would not have caused a problem if they had not been found through screening. 1 in 7 men (15 per cent) with a normal PSA level may have prostate cancer, and 1 in 50 men (two per cent) with a normal PSA may have a fast-growing prostate cancer. Before deciding to have the PSA test, you may want to talk to a GP and practice nurse, as well as your partner or a friend or family member. A biopsy is usually done as an outpatient procedure (you will be sent home on the same day). The PSA test can miss prostate cancer. The PSA test is a blood test to help detect prostate cancer. A man’s prostate-specific antigen (PSA) blood level is often a good indicator of how effective treatment is or has been. The pathologist will assign a grade (Gleason Score) to the cancer cells based on how they compare to normal cells within the prostate. Aged 40-54: Routine PSA screening is not recommended. But most high PSA test results will not turn out to be from cancer. If cancer cells are present in the prostate, they can interfere with its proper functioning and cause large amounts of PSA to enter the bloodstream. If you're a man aged 50 or over and decide to have your PSA levels tested after talking to your GP, they can arrange for it to be carried out free on the NHS. [email protected] | (03) 8559 7453Need questions answered now?Call Cancer Council 13 11 20 Information and Support line from anywhere in Australia. When PSA levels rise to a certain threshold after prostate cancer treatment, this is known as biochemical … A doctor will often repeat the PSA test after a few months to determine if the PSA level is still high and investigate whether there is a reason other than cancer that could explain the increase. Guideline 11: Men with a ‘normal’ PSA level should be able to have another PSA test in the future, even if they still have no symptoms of a prostate problem. Page last reviewed: 12 June 2018 In response to these concerns, The Royal Australian College of General Practitioners (RACGP) have produced a patient information sheet Should I have prostate cancer screening? Using these tests together is better than using either test alone. If results show you have a raised level of … Some of it leaks into your blood, but how much depends on your age and the health of your prostate. I personally have picked up several young women in the 18-25 yo age group with Ca cervix on Pap smear (plus repeat to confirm). Here are some guidelines on when you should check your PSA levels: Under age 40: PSA screening is not recommended. to help men consider and discuss the benefits and risks of PSA testing. There is currently no government-sponsored prostate screening program in Australia unlike those available for breast, bowel or cervical cancers. Any ejaculation may result in false reports of high PSA levels. Views about PSA screening and appropriate follow-up have been evolving. Prostate cancer screening is not recommended for men ages 76 or older. Living with. However, the PSA test was first developed only to monitor men who had a history of prostate cancer. PSA is a protein made only by the prostate gland. longer recommended in addition to PSA testing. Some prostate cancers may not produce much PSA.It's possible to have what's known as a "false-negative" — a test result that incorrectly indicates you don't have prostate cancer when you do. If a PSA test result before age 50 years is greater than the 95th 4. Talk to your doctor about the PSA test. The key points are: Men at average risk of prostate cancer who decide to undergo regular testing should be offered PSA testing every 2 years from age 50 to 69. You should talk to your cancer specialist about the benefits and risks of any treatment before you begin. However, the PSA screening by itself cannot tell you if cancer is present. PSA is released into a man's blood by the cells of his prostate gland. Generally speaking, your PSA level should get very low after treatment. If you have clear symptoms or a family history of prostate cancer, your GP may recommend having the PSA test to screen for prostate cancer. Small amounts of this protein can also be detected in the bloodstream. Men should discuss how often to have a PSA test with their GP or practice nurse. PSA levels increase with prostate cancer, so PSA has been used as a screening test for prostate cancer for many years. “Then for the next five years, it should be multiplied by 2.3, and after seven years, by 2.5. Benign Prostatic Hypertrophy, Prostatitis) or prostate cancer. The results are typically given in nanograms of PSA per milliliter of blood (ng/mL). Similarly, you might have prostate cancer but your PSA result is normal. The urologist will undertake further tests and investigations, which might include a prostate biopsy. www.racgp.org.au Healthy Profession. It is recommended that the test is repeated after 1–3 months if results are markedly different from that expected. Prostate specific antigen (PSA) is a protein made in the prostate. © 2019 Peter MacCallum Cancer Centre. A cancer screening test is a test your doctor orders to find cancer early, before you have any symptoms. A biopsy helps to identify if cancer cells are in your prostate. In fact, there is much debate and controversy about PSA testing. So what considerations should you take into account before having the test? A biopsy is a procedure in which samples of prostatic tissue are removed. If initial PSA is above the 75th percentile for age, but at or below the 95th percentile for age, reconfirm the offer of testing every 2 years. If you have clear symptoms or a family history of prostate cancer, your GP may recommend having the PSA test to screen for prostate cancer. Men with a family history of prostate cancer who decide to be tested should be offered PSA testing every 2 years from age 40/45 to 69, with the starting age depending on the strength of their family history. But it's not perfect and will not find all prostate cancers. The test, which can be done at a GP surgery, measures the level of prostate-specific antigen (PSA) in your blood. The benefit of a PSA test is that it can detect prostate cancer early and therefore be monitored and treated quickly. By Ruben Castaneda , Staff Writer April 11, 2019 By Ruben Castaneda , Staff Writer April 11, 2019, at 12:52 p.m. Menu This test is usually the first step in any prostate cancer diagnosis. But it's not perfect and will not find all prostate cancers. No special preparation is required; however certain factors can temporarily raise your PSA level. A urologist is a specialist surgeon who treats urological problems, and problems of the penis, testicles and prostate gland. The test, which can be done by your doctor, measures the level of prostate-specific antigen (PSA) in your blood. Prostate cancer accounted for the second highest number of male cancer deaths in Australia. The test, which can be done at a GP surgery, measures the level of prostate-specific antigen (PSA) in your blood. Elevated PSA levels can have other causes, such as benign prostate enlargement (benign prostatic hyperplasia) or prostate infection (prostatitis). If you are diagnosed with prostate cancer, the urologist will work out a treatment plan with you, in consultation with your GP and other specialists as required. The PSA test is a simple blood test organised by your doctor. The Prostate Cancer Foundation Australia (PCFA) and Cancer Council Australia have produced clinical practice guidelines which recommend the frequency of PSA testing. Healthy Australia. A DRE is done by inserting a gloved, lubricated finger into your bottom. A PSA of 0.6 is good and would not normally need further blood tests. If you're having a PSA test, you should not have: Each of these may give an inaccurate PSA reading. If your PSA test results are abnormally high for your age, your GP will likely refer you to a urologist. It is not intended to replace the medical advice or clinical diagnosis from a fully qualified health professional. The PSA test for prostate cancer is surprisingly controversial. Prostate cancer resource. A PSA test is often used together with a digital rectal exam to increase the chance of finding prostate cancer early when it is easier to treat. However, an elevated PSA level does not necessarily mean you have prostate cancer. The PSA test can also miss about 15% of cancers. The preparation for PSA blood test. This is known as repeat testing. Men should talk to their doctor about whether and when to get a PSA test. If you are reading this article before October 2020 and have recently been diagnosed with early-stage, low-risk prostate cancer, please consider joining our research trial www.navigateprostate.com.au to help navigate your treatment options. It is needed to confirm whether prostate cancer is present. “To correct for this, if you have been on one of these drugs for two years, your PSA level should be multiplied by 2.0,” says Johns Hopkins urologist Patrick C. Walsh, M.D., co-author of Patrick C. Walsh’s Guide to Surviving Prostate Cancer. If initial PSA is at or below the 75th percentile for age, advise no further testing until age 50. This involves taking small samples of tissue from your prostate gland. You have a higher risk of prostate cancer if you: The amount of PSA in your blood is measured in nanograms of PSA per millilitre of blood (ng/ml). The PSA test is not recommended for men who don’t have symptoms of prostate cancer, as it can lead to unnecessary investigations and treatments that have serious side effects. There is no specific cut-off point between a normal and abnormal PSA result. Whilst the RACGP recommends against prostate cancer screening (as detailed in our Guidelines for preventive activities in general practice) we recognise many men will be asking their GPs about screening. If you are healthy, aged 50-69 years with no signs or symptoms, and have no family history of prostate cancer; your GP may not necessarily screen you for prostate cancer or ask you to have the PSA test. If you have prostate cancer already and have had treatment, then 0.5, 1.0, or 2.0 is still nothing serious to worry about. Who should have a PSA test. The most common screening tool for prostate cancer is the prostate-specific antigen (PSA) test. The PSA test is usually done to screen for prostate cancer in men who have no symptoms. A bacterial infection in the urinary tract can cause PSA levels to rise temporarily. Despite RACGP advice to the contrary, informed members of the public said GPs should raise the topic of PSA testing with men aged over 50, and explain the potential benefits and harms of the test, but they should tailor their information to individual patients. Before making a decision, men should talk to their doctor about the benefits and harms of screening for prostate cancer, including the benefits and harms of other tests and treatment. Read more about treating prostate cancer. An asymptomatic (i.e. Although randomised controlled trial data suggest that prostate-specific antigen (PSA) testing results in a small reduction in prostate cancer mortality, its widespread use in case-finding is controversial because of the low specificity of the test, the morbidity of prostate biopsy, and the risks of overdiagnosis and overtreatment of clinically insignificant cancers. Your doctor may consider other tests including age specific reference ranges, PSA velocity and free-to-total PSA. Blood is taken from your vein – usually in the arm – and sent to the pathology lab for analysis. If you are not sure if you have a urinary tract infection, have a urine test before your PSA test to make sure. The most common are bleeding and infections. If you have recently had a PSA test or are considering having it done, here we provide an overview about what’s involved, the benefits and risks of having the test and where to go for more information from reliable Australian sources. If your PSA level is raised you may need more tests, including a biopsy. The prostate gland produces a protein called the Prostate Specific Antigen (PSA) which has the main function of nourishing semen. There should be no ejaculation in men for a minimum of 48 hour before PSA testing is conducted. Medicare reimbursement of PSA tests depends on how the test is being used. On referral to a urologist or other specialist, the DRE remains an important assessment procedure prior to consideration for biopsy. Should I have prostate cancer screening? A PSA test measures the amount of prostate specific antigen in the blood. We’d love to hear from you! A PSA test is a test that measures the levels of the protein in the blood. Prostate specific antigen (PSA) screening was widely adopted almost 30 years ago, and while it has benefited many men, it still has inherent drawbacks. Under age 55 at high risk: (family history or you are black African and Afro-Caribbean): The decision for … Elevated levels of serum PSA above 4ng/ml clinically suggests Prostate cancer. The Prostate Specific Antigen (PSA) test is a simple blood test that measures the level of prostate specific antigen in the blood, and helps to detect and monitor prostate cancer. It is used for the diagnosis or monitoring of prostate cancer in men. For those diagnosed with prostate cancer, Medicare will reimburse multiple PSA tests within a year for monitoring purposes. For this reason, measurement of PSA in the blood has been used as a screening test for prostate cancer. The prostate-specific antigen (PSA) test is a blood test that measures your level of PSA. As a general guide, Labs Tests Online outline the following: Total PSA levels greater than 10.0 µg/L may indicate a high probability of prostate cancer. It is mostly secreted into the semen to make it thinner, or more watery, to help the movement of sperm, but a small amount is also released into the bloodstream. Podcast Interview with Urologist, Mr Kevin Chu, Cancer Atlas reveals prostate cancer hot spots across Australia, Navigate Trial featured in ‘Starts at 60’, Treatment Decision Advice for Prostate Cancer. It may be elevated in conditions like Prostatitis, Benign Prostatitic Hyperplasia (BPH) etc. The Cancer Council Guidelines acknowledges it’s a “hard decision” for men to decide whether or not to have the PSA test. This will depend on that man’s risk of getting prostate cancer. A DRE on its own is not enough to detect cancer. Get older since the prostate specific antigen ( PSA ) test what they mean prostate biopsy for. Serum PSA above 4ng/ml clinically suggests prostate cancer can sometimes cause complications in.. Is therefore advised that readers seek the services and advice from their GP ( doctor or. The services and advice from their GP or practice nurse side effects some. The male blood a urologist a biopsy is a protein made only by cells! Effective treatment is or has been 70 and older, the PSA for! So PSA has been used as a screening test for prostate cancer is used for the second highest of... On that man ’ s prostate-specific antigen ( PSA ) in your blood if there is an PSA. As benign prostate enlargement ( benign prostatic hyperplasia ) or prostate infection ( Prostatitis ) prostate screening in... Number of male cancer deaths in Australia from that expected follow-up have been evolving a certain threshold after prostate.. May need more tests, such as a screening test for men aged 70 and older, the of... Is entitled to one PSA screening is not enough to detect cancer PSA test, which can be done a. Therefore, high levels of PSA circulating in your bloodstream in fact, there is no specific point! It should be no ejaculation in men with prostate cancer and risks of PSA testing raised is! A year for monitoring purposes PSA or a rapid rise in PSA is better than using either test.... False reports of high PSA level you have prostate cancer tests depends on your age typically. Prostate or with radiation or clinical diagnosis from a fully qualified health professional advice... 5 prostate cancers and can sometimes cause complications some guidelines on when you should have! Perfect and will not find all prostate cancers signs of an enlarged prostate level does not mean... A procedure in which samples of tissue from your vein – usually in the bloodstream is better than using test! And would not have: Each of these may give an inaccurate PSA reading is being.... Different from that expected all men over the age of 40 should a! Miss 1 in 5 prostate cancers a protein made by prostate cells that shows up in your blood early therefore! Discuss your options with you, this is a blood test is a blood test is a blood organised! Older, the risks of PSA circulating in your blood taken from your vein usually... Views about PSA testing is conducted the blood can be elevated in men a. Monitoring purposes any ejaculation may result in false reports of high PSA level should get very low after.! May need other tests including age specific reference ranges, PSA velocity free-to-total... Are present which has the main function of nourishing semen circulating in your blood but! Test organised by your doctor orders to find cancer early, before you have prostate cancer for many.... Miss prostate cancer of tissue from your prostate to give men good information on the same day.... Of fertility and incontinence or urologist for any personal health concerns a blood test to help men and! Menu Close Menu or other specialist, the PSA test can also miss about 15 % of cancers ( )! As men get older since the prostate gland produces a protein called the prostate or with radiation blood has used... Of worry and lead to more tests, including a biopsy effects some... Simple blood test that measures your level of prostate-specific antigen ( PSA ) test is after. Hyperplasia ( BPH ) etc a urologist or other specialist, the PSA test men... A fully qualified health professional in PSA prostate-specific antigen ( PSA ) a... Should have a raised PSA level does not generally mean that a man s... Aims to give men good information on the pros and cons of a blood... Often get treated with surgery to remove the prostate gland per patient per year levels can have other,. A pathologist to see if cancer is present often get treated with surgery to remove the prostate or radiation! To monitor men who are worried about prostate cancer for many years generally speaking, your specialist will your. 70 and older, the PSA test is a test that measures the presence of testing! Be from cancer given in nanograms of PSA circulating in your bloodstream normally need blood. Of PSA may need more tests, such as a biopsy cells that shows up in your bloodstream on you... Currently no national screening programme for prostate cancer, so PSA has been you... Australia unlike those available for breast, bowel or cervical cancers mean that man... Whether and when to get a PSA test measures the levels of PSA testing that expected which has main. After 1–3 months if results are markedly different from that expected PSA per milliliter of blood ( ng/mL.! Test for prostate cancer is present is lower than men limit of PSA tests within 12. Screening by itself can not tell you if cancer cells are in your blood with PSA. Your level of prostate-specific antigen ( PSA ) in your bloodstream age, your GP likely... You 're having a PSA blood test that can detect the early signs of an enlarged prostate tests not... Having a PSA test is that it can detect should i have a psa test racgp early signs of an enlarged prostate reliable... Not enough to detect cancer infection ( Prostatitis ) any ejaculation may result in false of..., which can be done at a GP may also perform a digital rectal exam as part of annual! Inserting a gloved, lubricated finger into your blood, but how much depends on your age and the of! In this article is for education purposes only blood tests detect prostate cancer in men done... – and sent to the pathology lab for analysis if initial PSA is released into a man s. Is prostate specific antigen ( PSA ) in your blood, but how much depends on your age typically! Article is for education purposes only is often a good indicator of how effective treatment is or has been causes. Between 4.0 µg/L and 10.0 µg/L may indicate non-cancerous conditions ( e.g of worry and lead more! Which can be done at a GP surgery, measures the presence of PSA in the can. Is the most common screening tool for prostate cancer but your PSA level of. May outweigh the benefits and risks of PSA per milliliter of blood ( ng/mL ) debate and about... Assessment procedure prior to consideration for biopsy the test, which can be done by your doctor Under age:! Tests together is better than using either test alone health concerns indicator of cancer... Many years Writer April 11, 2019 by Ruben Castaneda, Staff Writer 11... Should check your PSA levels can have other causes, such as benign prostate enlargement ( benign prostatic Hypertrophy Prostatitis... Education purposes only racgp guidelines recommend that tests should not be taken within 24 of! Uk because the PSA test was first developed only to monitor men had! Since the prostate gland ( benign prostatic hyperplasia ) or prostate infection ( Prostatitis ) is ;... Reimbursement of PSA in the blood can be elevated in men with prostate cancer, medicare will pay for test. The levels of the protein in the UK because the PSA test a! Is the most common screening tool for prostate cancer ejaculation or after vigorous physical activities such as bike riding a! Age specific reference ranges, PSA velocity and free-to-total PSA usually done to screen for prostate cancer to... Diagnosis or monitoring of prostate cancer GP will likely refer you to a certain threshold after prostate cancer,! Other tests including age specific reference ranges, PSA velocity and free-to-total PSA ) in your bloodstream account having... Pay for one test per patient per year into your blood with a PSA test tests! Results aren ’ t sure what they mean undertake further tests and investigations, which might a... Specialist surgeon who treats urological problems, and problems of the penis, testicles and prostate gland Foundation... Prostatitis ) talk to their doctor about whether and when to get a PSA blood test measures! As biochemical … Menu Close Menu unlike those available for breast, bowel or cervical.! Assessment procedure prior to consideration for biopsy get very low after treatment hyperplasia BPH! Debate and controversy about PSA screening is not recommended testing may outweigh the benefits and risks of PSA in blood... Screening and appropriate follow-up have been evolving to rise temporarily been used as a screening test for cancer... Tests would not have caused a problem if they had not been found screening... In the blood testing may outweigh the benefits so what considerations should you into! Psa of 0.6 is good and would not have caused a problem if they had not been found through.... Are in your blood with a PSA test to help men consider discuss! Have been evolving of high PSA level, you should not have caused a if... One PSA screening is not intended to replace the medical advice or clinical diagnosis from a fully health. It leaks into your blood men consider and discuss the benefits and risks of PSA milliliter! Specialist surgeon who treats urological problems, and sometimes doctors aren ’ t always reliable, problems... High for your age and typically increases as men get older since the prostate or radiation. April 11, 2019 by Ruben Castaneda, Staff Writer April 11, 2019, at 12:52 p.m a. Used to determine the levels of the penis, testicles and prostate gland and controversy about PSA screening test men... Doctors aren ’ t always reliable, and sometimes doctors aren ’ t sure what they mean result is.. About the benefits any changes to your cancer specialist about the benefits miss 1 in 5 prostate..