- Total PSA exam values
- When to perform the Free PSA exam
- PSA density and speed
- What can cause PSA to rise
PSA, known as Prostatic Specific Antigen, is an enzyme produced by prostate cells whose concentration may indicate changes in the prostate, such as prostatitis, benign prostatic hypertrophy or prostate cancer, for example. The PSA test is simple and painless and is done in the laboratory by collecting a small blood sample.
Generally, healthy men have total PSA values below 4 ng / ml, but this value may be altered or slightly increased according to age and the laboratory where the analysis was performed. In addition, the increase in total PSA concentration is not always indicative of prostate cancer, and further tests are necessary to confirm the diagnosis.
However, in the case of prostate cancer, the PSA value may also remain normal and, therefore, the suspicion of cancer should always be confirmed with other diagnostic tests, such as digital rectal examination, MRI and biopsy.
Total PSA exam values
Generally, when an individual has a total PSA value greater than 4.0 ng / ml, it is recommended to repeat the test to confirm the value, and if it is maintained, it is essential to do other tests to confirm the diagnosis and identify the cause. Know other tests to evaluate the prostate.
In most cases, the higher the total PSA value, the more prostate cancer is suspected, so when the value is greater than 10 ng / ml the chances of developing prostate cancer are 50%. The PSA value may vary with the age, habits of the person and the laboratory where the test was performed. In general, the PSA reference values are:
- Up to 59 years: total PSA up to 4.0 ng / mL; Between 60 and 69 years: total PSA up to 4.5 ng / mL; From 70 years old: total PSA up to 6.5 ng / mL.
However, in some cases, the man with a PSA of 2 ng / ml and with nodules on the rectal examination is at higher risk of having prostate cancer than the person who has only the highest value without changes in the rectal examination, for example.
In order to really know if there is any change in the prostate, the medium recommends performing the measurement of free PSA and the relationship between free PSA and total PSA, which is essential for the diagnosis of prostate cancer.
When to perform the Free PSA exam
Generally, when the patient has total PSA between 2.0 and 10 ng / ml, the urologist indicates that the PSA test should be performed, as there are high chances of developing prostate carcinoma. Based on the result of free and total PSA, a relationship is made between these two results to verify whether the change in the prostate is benign or malignant, in which case a prostate biopsy is recommended.
When the ratio between free and total PSA is greater than 20%, it is an indication that the enlarged prostate is benign, which may indicate that you are developing benign diseases, such as benign prostatic hypertrophy or urinary tract infection, for example. However, when this ratio is less than 20%, it is usually indicative of prostate cancer, and a prostate biopsy is recommended to confirm the diagnosis and initiate treatment, which in some cases is done with radiotherapy and chemotherapy. Understand how the prostate biopsy is done.
PSA density and speed
The urologist can also assess the density and velocity of PSA, the greater the density of PSA, the greater the suspicion of the presence of prostate cancer and, in the case of the value of PSA velocity, increasing by more than 0.75 ng / ml per year or increase very quickly it is essential to repeat the tests, as it may indicate cancer.
What can cause PSA to rise
Several situations can cause the PSA value to increase, such as:
- Inflammation of the prostate, known as acute or chronic prostatitis; Urinary or genital infection; Acute urinary retention; Benign prostatic hypertrophy, known as BPH; Carrying out medical procedures such as cystoscopy, digital rectal examination, biopsy, prostate surgery or trans-urethral resection prostate cancer; prostate cancer.
In addition to these most common causes, increasing age, cycling and taking some medications, such as male hormones such as testosterone can lead to increased PSA.
Normally, a PSA blood test is indicated by the urologist in case of urinary changes, during treatment for prostate cancer and after surgery and in all men at least once a year from 45 years of age.
