The PSA Test Explained

Have you been told that a PSA test would be a good idea? Perhaps you have heard the PSA test mentioned and would like to know more. Developed in the late 1970s, the PSA test has been used to screen for prostate cancer since the mid-1980s. The PSA test is a blood test which measures the level of prostate-specific antigen (PSA) in the blood. PSA is produced by both cancerous prostate cells and healthy ones. PSA levels naturally rise with age, but can be noticeably higher than average in men with prostate cancer. The test in itself does not diagnose cancer, it simply indicates that, should a raised level of PSA be detected, there may be a need for further investigation.

What are the advantages of the PSA test?

The PSA test can show raised levels of PSA, which may be a symptom of prostate cancer. Frequently no other signs of cancer will yet be apparent. If a raised PSA level is used as a basis for further investigation, fast-growing tumors may be picked up early, allowing intervention before the cancer has spread.

Things to think about

Although the PSA test may show raised levels of PSA, this may not indicate cancer. There are many other issues which can cause raised PSA levels, including natural ageing.

The PSA test can miss cancer! Around 15% of prostate cancer sufferers have normal PSA levels, including a minority who have fast-growing tumours.

Even if a PSA test is raised and further testing shows the presence of a tumour, in many cases it will be a slow-growing one which is unlikely to cause any issues. In such circumstances, watchful waiting or active surveillance (monitoring the tumour but not treating it) are often the preferred options. Some men can find the idea of having cancer but no treatment being appropriate hard to live with.

Invasive investigations to the prostate, or treatment, can have serious side effects, including incontinence and erectile dysfunction. Although the PSA test can have benefits, it’s important to discuss the test implications with a suitably experienced and qualified medical professional before deciding whether to have it.