Q. Is there any preparation required before the PSA test?
You should not have produced semen during sex or masturbation (ejaculated) in the previous 48 hours or Exercised heavily in the previous 48 hours. You should not have undergone a prostate biopsy in the previous six weeks or had a rectal examination (a digital rectal examination) in the previous week.
Q. What factors can affect the test results?
The PSA levels in the blood can be affected by a number of factors including:
· Ejaculation
· Direct prostate examinations
· Physical activities like cycling, horse-riding, etc.
· Chemotherapy
· Infections of the prostate gland
· Prostate Biopsy
· Cystoscopy (a procedure where an endoscope is inserted through the urethra to examine the urinary bladder)
· Urinary catheter
· Urinary tract infections
Q. What additional tests can be prescribed by your doctor in case the result of PSA test is not normal?
Additional tests that may be prescribed in case of abnormal PSA test result are:
· Digital Rectal Examination (DRE)
· Free PSA Test
· Urinalysis
· Prostate Ultrasound
· Prostate Biopsy
Q. What other ways are the PSA test results evaluated to help in diagnosis?
PSA Test results can also be evaluated in the following ways:
· PSA Velocity: Estimates increase or decrease in PSA levels over time. A significant increase indicates cancer. Faster the increase in PSA, more aggressive is the cancer.
· PSA Doubling Time: Also tracks PSA increase by measuring the time in which PSA levels double.
· PSA Density: Measures PSA levels in blood against volume of the prostate gland seen by ultrasound. Greater PSA levels than expected for the visible volume of prostate indicate chance of cancer.
· Age-specific PSA: PSA levels increase with age, hence the normal range of PSA is to be established for the age of the particular person being tested.
Q. What is BPH?
Benign Prostatic Hyperplasia or BPH is a condition characterized by enlargement of the prostate gland. Enlargement due to BPH is usually caused due to aging and does not develop into cancer. The enlarged prostate puts pressure on the urethra and leads to blockage, causing urinary retention, weak or no urine flow, urinary bladder stones, infections or kidney damage.
Q. Can the PSA test detect all types of prostate cancer?
Increased PSA level is usually an indication of prostate cancer. However, it cannot confirm the diagnosis of cancer since elevated PSA levels can be seen in other conditions as well. Also, PSA levels are not significantly increased in slow growing forms of prostate cancer and many times prostate cancer can occur without increased PSA levels. PSA is usually accompanied by other tests like Digital Rectal Examination and biopsy to confirm the diagnosis of cancer.
Q. Is there any risk associated with this test?
There is no risk associated with the test. However, since this test involves a needle prick to withdraw the blood sample, in very rare cases, a patient may experience increased bleeding, hematoma formation (blood collection under the skin), bruising or infection at the site of needle prick.