What is PSA?

PSA stands for Prostate-Specific Antigen, and it is one of the most common tests ordered by urologists.

It is a protein secreted by the prostate gland, detectable in both blood and semen. It is produced by both normal prostate cells and prostate cancer cells.

What does an elevated PSA level indicate?

An elevated PSA level may suggest various conditions, including:

• Prostate cancer
• Benign prostatic hyperplasia (enlarged prostate)
• Acute prostatitis (prostate inflammation)
• Urinary tract infection

It could also be influenced by:

• Recent ejaculation
• Recent digital rectal examination of the prostate
• Recent cystoscopy (bladder examination)
• Prolonged bike riding

Therefore, if there has been recent ejaculation, vigorous cycling, or recent examinations like a digital rectal exam or cystoscopy, it is recommended to wait one to two weeks before accurate blood collection.

Purpose of PSA testing? Early detection and treatment of Prostate Cancer

The primary purpose of PSA testing is to detect prostate cancer early for prompt treatment. Prostate cancer in its early stages often presents with no symptoms.

When should one undergo PSA testing?

According to the American National Comprehensive Cancer Network (NCCN) guidelines:

• Generally, individuals aged 45 and above are advised to start PSA testing.
• Those with a family history of prostate cancer should consider starting at age 40.
• Individuals over 75, if in good health and never tested before, may consider PSA testing.

What to do if PSA is elevated? Do you need medication?

When Dr. Wu informs patients of an elevated PSA, a common question is, “What medication should I take?”

Actually, unlike elevated blood lipids or glucose, an elevated PSA does not necessarily involve medication in most cases. The underlying cause of PSA elevation could be related to various diseases or conditions, and Dr. Wu needs to determine the reason behind the elevated PSA.

Typically, through history-taking and a physical examination, the doctor can assess whether acute prostatitis or urinary tract infection may be causing the elevation. If no evident infection or inflammation is found, the primary concern is prostate cancer.

How is prostate cancer diagnosed? Doctors may recommend further tests such as magnetic resonance imaging (MRI) or tissue biopsy for a definitive diagnosis. Dr. Wu will discuss this in more detail later.