interpreting psa results - mercy health foundation

A Catholic healthcare ministry serving Ohio and Kentucky Understanding the PSA Test and its Results Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood. What is a normal PSA test result? There is no specific normal or abnormal PSA level in the blood, and many levels may vary over time in the same man. Most doctors usually consider PSA levels of 4.0 ng/mL and lower as normal. However, recent studies have shown that some men with PSA levels below 4.0 have prostate cancer, and many men with higher levels do not have prostate cancer. The most important factor is routine PSA involvement and seeing how levels change each year. What to do if elevated PSA Result? • If a man who has no symptoms of prostate cancer gets screened and has an elevated PSA, another test may be recommended to confirm the original finding • If a man’s PSA level continues to rise or if a suspicious lump is detected during a DRE, the physician may recommend additional tests to determine the nature of the problem • If prostate cancer is suspected, the doctor will recommend a prostate biopsy. During this procedure, multiple samples of prostate tissue are collected by inserting hollow needles into the prostate and then withdrawing them. • Elevated PSA levels can also be caused by medical procedures, BPH, recent sexual intercourse, or prostate inflammation/infection Limitations and potential harms Many tumors found through PSA testing grow so slowly that they are unlikely to threaten a man’s life. Two common potential harms exist in this case: • Overdiagnosis- Detecting tumors that are not life threatening, which lead to unnecessary treatment. • Overtreatment- Treating these tumors that are non-life threatening. Active Surveillance is a viable option for small, low- risk tumors. Overtreatment exposes men unnecessarily to the potential complications and harmful side effects of treatments for early prostate cancer, including surgery and radiation therapy.

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Page 1: Interpreting PSA Results - Mercy Health Foundation

A Catholic healthcare ministry serving Ohio and Kentucky

Understanding the PSA Test and its Results

Prostate-specificantigen,orPSA,isaproteinproducedbynormal,aswellasmalignant,cellsoftheprostategland.ThePSAtestmeasuresthelevelofPSAinaman’sblood.Forthistest,abloodsampleissenttoalaboratoryforanalysis.TheresultsareusuallyreportedasnanogramsofPSApermilliliter(ng/mL)ofblood.

WhatisanormalPSAtestresult?ThereisnospecificnormalorabnormalPSAlevelintheblood,andmanylevelsmayvaryovertimeinthesameman.MostdoctorsusuallyconsiderPSAlevelsof4.0ng/mLandlowerasnormal.However,recentstudieshaveshownthatsomemenwithPSAlevelsbelow4.0haveprostatecancer,andmanymenwithhigherlevelsdonothaveprostatecancer.ThemostimportantfactorisroutinePSAinvolvementandseeinghowlevelschangeeachyear.

WhattodoifelevatedPSAResult?• Ifamanwhohasnosymptomsofprostatecancergets

screenedandhasanelevatedPSA,anothertestmayberecommendedtoconfirmtheoriginalfinding

• Ifaman’sPSAlevelcontinuestoriseorifasuspiciouslumpisdetectedduringaDRE,thephysicianmayrecommendadditionalteststodeterminethenatureoftheproblem

• Ifprostatecancerissuspected,thedoctorwillrecommendaprostatebiopsy.Duringthisprocedure,multiplesamplesofprostatetissuearecollectedbyinsertinghollowneedlesintotheprostateandthenwithdrawingthem.

• ElevatedPSAlevelscanalsobecausedbymedicalprocedures,BPH,recentsexualintercourse,orprostateinflammation/infection

Limitationsandpotentialharms

ManytumorsfoundthroughPSAtestinggrowsoslowlythattheyareunlikelytothreatenaman’slife.Twocommonpotentialharmsexistinthiscase:• Overdiagnosis-Detecting

tumorsthatarenotlifethreatening,whichleadtounnecessarytreatment.

• Overtreatment-Treatingthesetumorsthatarenon-lifethreatening.ActiveSurveillanceisaviableoptionforsmall,low-risktumors.Overtreatmentexposesmenunnecessarilytothepotentialcomplicationsandharmfulsideeffectsoftreatmentsforearlyprostatecancer,includingsurgeryandradiationtherapy.

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