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2023-09-22T00:00:00.000-04:00

Understanding PSA Testing

Understanding PSA Testing

What is a PSA test?

PSA stands for prostate specific antigen, a protein produced by the prostate gland.1 The level of PSA in your blood is measured by a blood test. Levels higher than 3 nanograms per milliliter (ng/mL) indicate there may be an issue with your prostate that should be investigated further.1,2 

PSA stands for prostate specific antigen, a protein produced by the prostate gland.1 The level of PSA in your blood is measured by a blood test. Levels higher than 3 nanograms per milliliter (ng/mL) indicate there may be an issue with your prostate that should be investigated further.1,2 

Why have a PSA test?

The decision to have a PSA test can be tricky. This is because there is no standard level of PSA, plus the level of PSA in your blood can change every day. In addition, you may have ‘normal’ PSA levels but still have prostate cancer.1,2

If you have symptoms that could be related to an enlarged prostate, it might be a good idea to get a PSA test. Symptoms that could be a warning of a prostate problem include:2

  • Trouble urinating
  • Blood when you urinate or ejaculate
  • Pain when urinating
  • Needing to go all the time or through the night
  • Back or pelvic pain

The decision to have a PSA test can be tricky. This is because there is no standard level of PSA, plus the level of PSA in your blood can change every day. In addition, you may have ‘normal’ PSA levels but still have prostate cancer.1,2

If you have symptoms that could be related to an enlarged prostate, it might be a good idea to get a PSA test. Symptoms that could be a warning of a prostate problem include:2

  • Trouble urinating
  • Blood when you urinate or ejaculate
  • Pain when urinating
  • Needing to go all the time or through the night
  • Back or pelvic pain

Who does it?

A PSA test is a simple blood test than can be done through your Primary Care Physician.1 

A PSA test is a simple blood test than can be done through your Primary Care Physician.1 

What might the results mean?

It’s important to know that a PSA test is not a test for prostate cancer. An elevated level of PSA in your blood could mean a variety of things, from an enlarged prostate that is benign (not cancerous), inflammation or an infection, to a slow-growing cancer or more aggressive prostate cancer.2

You may get what’s called a ‘false positive’ or ‘false negative’ result. A false positive is where your PSA levels appear high, but you don’t have cancer. A false negative is the opposite, where the PSA levels appear within the normal range, but you do have prostate cancer. Both are stressful and can lead to more invasive testing being required (such as a biopsy) or to cancer being missed.2

It’s important to know that a PSA test is not a test for prostate cancer. An elevated level of PSA in your blood could mean a variety of things, from an enlarged prostate that is benign (not cancerous), inflammation or an infection, to a slow-growing cancer or more aggressive prostate cancer.2

You may get what’s called a ‘false positive’ or ‘false negative’ result. A false positive is where your PSA levels appear high, but you don’t have cancer. A false negative is the opposite, where the PSA levels appear within the normal range, but you do have prostate cancer. Both are stressful and can lead to more invasive testing being required (such as a biopsy) or to cancer being missed.2

PSA test is positive - what next?

If your PSA test comes back and your PSA levels are higher than 3 ng/mL your doctor will discuss next steps with you.1,2 This could include additional tests such as a digital rectal exam  (your provider will insert their finger into the rectum to feel for an enlarged prostate), a scan of the area with magnetic resonance imaging (MRI) or a prostate biopsy (where a small piece of prostate tissue is removed and examined for signs of cancer cells).2 Following these tests you and your healthcare team will make a plan of action depending on the results.  

If your PSA test comes back and your PSA levels are higher than 3 ng/mL your doctor will discuss next steps with you.1,2 This could include additional tests such as a digital rectal exam  (your provider will insert their finger into the rectum to feel for an enlarged prostate), a scan of the area with magnetic resonance imaging (MRI) or a prostate biopsy (where a small piece of prostate tissue is removed and examined for signs of cancer cells).2 Following these tests you and your healthcare team will make a plan of action depending on the results.  

References:

  1. Cancer Council. Understanding prostate cancer. Reviewed March 2022. Available from: https://www.cancercouncil.com.au/prostate-cancer/about-prostate-cancer/ (accessed August 2023). 
  2. Prostate Cancer Foundation of Australia. Should I have a PSA test?. Available from: https://www.cdc.gov/cancer/prostate/basic_info/get-screened.htm (accessed August 2023).