PSA - What Does Rising Prostate Specific Antigen Mean
What is PSA
Prostate specific antigen (PSA) is a protein produced by the prostate glands, and is commonly used as a marker for the presence and progression of prostate cancer. The American Cancer Society places prostate cancer as the second leading cause of cancer death in North American men, with about 1 man in 36 dying from the disease. Because of this more and more men are going to their physicians to have their PSA levels tested, in effort to screen for early stages of prostate cancer. PSA is not the most accurate measurement for the diagnosis of prostate cancer, however, and a high PSA test can cause considerable worry and anxiety in men.
Healthy men produce PSA every single day, as PSA is a protein designed to support liquefaction of semen and the movement of sperm. In the 1990's scientists discovered that prostate cancer cells also produce PSA levels, and as prostate cancer cells grow and spread, PSA levels also rise to abnormally high levels in the body. From the prostate, where the proteins are produced, PSA moves to other fluids in the body, including semen, urine and blood. Serum blood PSA tests revealing between 4 and 10 ng/mL (nanograms per millilitre) are considered suspicious and possibly a sign of prostate cancer. But despite the widespread use of PSA testing for cancer, studies have shown that high PSA levels is not the most accurate sign of disease.
Problems with PSA Testing
According to the U.S. Preventive Services Task Force, between 10-12% of men tested for prostate cancer using the PSA screening test return a false positive. This is because obesity, cancer, aging, race, prostatitis, benign prostate hyperplasia and recent ejaculation all increase PSA levels in the body and can confuse the diagnosis. In addition, up to 50% of men with prostate cancer fail to show clinically high PSA levels during screenings. All these factors combined have led physicians to rely on PSA testing less and less. If a man's blood test does reveal high PSA levels, it does not definitively mean that he has prostate cancer, but he should continue to explore the issue further with other types of tests.
While many men die from prostate cancer each year, doctors still regard it as one of the slowest growing of all cancers. So much so, that in the majority of cases, men are completely asymptomatic and have no idea that they have the disease. Depending on the individual case, doctors may recommend that men with mild stages of prostate cancer do not undergo treatment. Surgery, radiation and chemotherapy all come with a wide spectrum of negative side effects (loss of hair, poor libido, erectile dysfunction, reduced urinary control, etc), creating distress in men who would be otherwise symptom-free for many decades with just the cancer. Many men explore alternative treatments, such as medicinal Asian mushroom extracts and traditional herbal therapies. Following cancer treatment, levels of PSA should reduce to insignificant numbers. Physicians may recommend that following a curative treatment, men have a PSA test done each year to check for recurrence of prostate cancer.