Prostate Cancer Detection-How to detect prostate cancer?

Prostate-specific antigen (PSA) 

Prostate-specific antigen (PSA) is a substance made by the cells of the prostate gland (both normal cells and cancer cells). PSA is found primarily in semen. A percentage is also found in the blood.

Tests are often used to screen for prostate cancer...

Prostate-specific antigen (PSA) test: measures PSA levels in the blood.  In prostate cancer, PSA levels in the blood may be high in men. PSA levels can also be elevated in other conditions that affect the prostate.

When prostate cancer is established, PSA levels usually rise above 4. Still, a level below 4 does not ensure that a man does not have cancer. About 15% of men with a PSA less than 4 will have prostate cancer on biopsy.

Men with a PSA level between 4 and 10 have a chance of growing prostate cancer. If the PSA is greater than 10 the probability of prostate cancer is greater than 50%.

If your PSA level is high, your doctor may suggest either waiting a while and repeating the test or getting a prostate biopsy to find out if you have cancer. When considering whether to perform a prostate biopsy to look for cancer, not all doctors use the exact same PSA cutoff point. Some may encourage it if the PSA is 4 or higher, while others may recommend starting at a lower level Other factors like your age, race, and family history may affect this choice.

Factors that can affect PSA levels

Other factors besides prostate cancer can also raise PSA levels:

Older age: 

PSA levels usually rise slowly as you age, even if you don't have prostate problems.

Prostatitis:

 This term describes infection or inflammation of the prostate gland, which can raise PSA levels.

Ejaculation:

 This can cause the PSA to go up for a while, and then go down again. This is why some doctors recommend that men avoid ejaculating for a day or so before the test.

Cycling: 

Some research studies have actually suggested that cycling can raise PSA levels (perhaps because the seat puts pressure on the prostate), although not all studies have actually found this to be the case.

Certain urologic treatments: 

Some treatments performed at the doctor's workplace that affect the prostate, such as prostate biopsy or cystoscopy, can temporarily cause elevated PSA levels. Some studies have actually suggested that a digital rectal exam (DRE) may raise PSA levels somewhat, although other studies have not actually found this. Still, if both a PSA test and a DRE are being performed during the doctor's check-out, some physicians recommend that blood be drawn for the PSA before the DRE is performed.

Certain medications: 

Taking male hormonal agents such as testosterone (or other medications that increase testosterone levels) can cause PSA to rise.

Certain types of PSA tests

Some doctors may consider using different types of PSA tests (below) if you need a prostate biopsy, but not all doctors agree on how to use these other PSA tests. If your PSA test result is truly abnormal, ask your doctor to discuss your cancer risk and the need for more tests.

Percentage-free PSA: PSA exists in the blood in 2 main forms. One type is bound to blood proteins, while the other distributes free (unbound). Percent free PSA (fPSA) is the ratio of total free circulating PSA to the total PSA level. The proportion of free PSA in men with prostate cancer is lower than in men who do not.

This test is often used to help decide if your PSA results are in the borderline range (such as between 4 and 10). A low percentage of free PSA indicates that you are more likely to have prostate cancer and should probably have a biopsy.

Many doctors recommend a biopsy for men with a percentage of free PSA of 10% or less and recommend that men consider a biopsy if it is between 10% and 25%.  This test is widely used, but not all medical professionals agree that 25% is the best cut-off point for deciding on a biopsy, and the cut-off can change depending on the overall PSA level...

Complexed PSA:

 This test directly measures the amount of PSA that is bound to other proteins (the part of PSA that is not "free"). This test can be done instead of testing for total and completely free PSA, and it can provide the same amount of information as other tests done independently.

Tests that combine different PSA types: 

Some newer tests, such as the Prostate Health Index (phi) and 4Kscore tests, combine the results of different PSA types to get an overall score that reflects the chance. That a person gets a chance to get prostate cancer. These tests may be useful for men with slightly elevated PSA to help determine whether they should have a prostate biopsy. Certain tests can be used to help identify whether a man who has already had a prostate biopsy that did not find cancer should have another biopsy.

PSA speed:

 PSA speed is not a different test. This is a measure of how fast the PSA rises over time. Generally, PSA levels rise slowly with age. Some research has shown that these levels rise more quickly if a man has cancer, but research studies have actually shown that PSA velocity is more helpful in detecting prostate cancer than PSA levels themselves. Is. For this reason, the ACS guidelines do not recommend using PSA velocity as part of prostate cancer.

PSA density:

 Men with larger prostate glands have higher PSA levels. PSA density (PSAD) is often used in men with an enlarged prostate gland to try to reverse it. The doctor measures the volume (size) of the prostate gland with transrectal ultrasound (talked about if the results of the prostate cancer screening test are not normal) and divides the PSA number by the volume of the prostate. A higher PSA density suggests a higher chance of cancer. PSA density has not actually been shown to be as beneficial as the percentage-free PSA test.

PSA ranges by age:

 PSA levels are usually higher in older men than in younger men, even when there is no cancer. A PSA result may be very worrisome in a 50-year-old man but of less concern in an 80-year-old man. For this reason, some doctors actually recommend comparing PSA results with other men of the same age.

However, due to the fact that the effectiveness of age-specific PSA ranges is not well established, many medical professionals and professional companies (as well as PSA test manufacturers) do not currently recommend their use.