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What is PSA Blood Test? Preparation and Normal Ranges for PSA Blood Test

Have you ever wondered what the PSA blood test meant after reading your doctor’s prescription? I am sure there are quite a few who would like to know more about the test especially its name and what it meant. There are some tests that you should definitely opt for once you have crossed 50 years of age, especially men. Cancer, especially prostate cancer has the highest number of cases each year and it’s been rising steadily each year.

According to the Cancer India Organization, the prostate is among the top 10 areas of cancer in India based on Globocan 2012. It is the second-leading type of cancer among men in cities like Delhi, Pune, Kolkata, and Thiruvananthapuram, while it is the third leading cause of cancer in Mumbai and Bengaluru. The rates of incidence for this cancer are increasing every day and are projected to double by the year 2020.

The survival rate of patients in India varies with age, though the average 5-year survival rate is 64 percent. For patients below 55 years of age, it is 55 percent, those between 60-69 years is 74 percent and for patients above 70 years it falls down to 52 percent. Prostate cancer that is detected early when it is still in the prostate gland, has better chances of being treated successfully.

Early detection is possible through a screening test known as the PSA test i.e. the Prostate- Specific Antigen Blood Test. A substance produced by the prostate gland is known as Prostate specific antigen(PSA). The PSA Blood Test is done to check the levels of the same, where PSA blood test results may indicate prostate cancer, or conditions like prostatitis which is non-cancerous, or even an enlarged prostate. Another test that can also be used to check for cancer is the digital rectal exam. If the test results prove to be inconclusive then further tests are recommended to check for cancer.

Let’s understand the PSA test better.

PSA Blood Test:

A test which measures the quantity of prostate-specific antigen in your blood. The PSA is the protein that is produced by both the normal as well as the cancerous cells in the prostate. All men have some amount of PSA in their blood which could increase as they age. An increase in the level of PSA in the blood can indicate a problem with the gland, which may or may not be cancer.

Who Can Have a Prostate Specific Antigen(PSA) Test Done?

All men above 50 years of age should get this test done once they have understood the advantages and drawbacks of it. Those who are above 45 years of age, but have a higher risk of developing prostate cancer may want to discuss with their doctors and get the test.

Factors Affecting Your PSA Levels

  • A urine infection
  • Energetic exercises such as cycling 2 days before the PSA blood test
  • Ejaculation 48 hours before taking the test
  • Anal sex or prostate stimulation during sex may increase your levels
  • Getting a Digital Rectal Exam before the test
  • If you had a prostate biopsy a month and a half before the PSA test
  • Other diagnostic tests or surgeries on your bladder, prostate or a catheter. It is prudent to get the test done 6 weeks after the surgery.
  • If you are on medication for urine infection or any other issue

What do the PSA Blood Test Results Indicate?

A high PSA level may be a mark of an issue with your prostate. They could mean.

  • An enlarged prostate
  • Prostatitis which is an infection or swelling of the prostate gland
  • Urine infection
  • Prostate cancer

There could be a number of reasons for the increase in the PSA levels. Quite a few times those with higher PSA levels do not suffer from prostate cancer, while those with a normal level may suffer from cancer. You may suffer from cancer if

  • Are 50 years or more
  • Have a father or brother below 60 years who suffer from prostate cancer
  • If your mother or sister were diagnosed with breast cancer before they were 60, which could mean a flaw in the BRCA1 and BRCA2 genes.
  • Are overweight or obese, which increases the chances of suffering from aggressive or advanced prostate cancer

What is the PSA Blood Test Normal Range?

The level of PSA in blood considered to be normal depends on your age. If you are

  • between 50-59 years – the PSA should be below 3 ng/ml
  • between 60-69 years – the PSA should be below 4 ng/ml
  • 70 years and above – the PSA should be below 5 ng/ml

If your PSA is considered to be high, then the doctor may ask for further investigations. If you have normal PSA levels despite your age, then it requires no further investigations.

Advantages of Taking a PSA Test

  • This test can help you detect prostate cancer before there are indications of the disease
  • It could help you detect aggressive cancer at an early stage, which can then be treated to prevent the spread of cancer to other parts of the body
  • Most often prostate cancer is slow moving and this test may help you keep an eye on the same so that you can get the right medications on time
  • Those who are at a higher risk of suffering from prostate cancer may be able to track any changes in their PSA levels, which may indicate cancer.

Though there are Quite a Few Benefits, a PSA Blood Test Does have Its Drawbacks

  • Your PSA levels could be high even if you don’t suffer from cancer
  • A raised Prostate specific antigen(PSA) does not necessarily indicate you have prostate cancer. This means you would need to get tested further. One of the tests could be a prostate biopsy. This biopsy could lead to pain, infection blood in the semen and the urine. Three men among 50 are at a risk of getting infected after a biopsy
  • This test at times fails to detect cancer. The incidence of false negative tests is nearly 2% among 50 men.
  • Getting treated for cancer has side effects on your daily life too, such as urine and bowel problems or issues maintaining an erection.

You would need to understand the whole gamut of the tests and how it may affect you before you make a decision to take the test.

Medically Reviewed By
Dr. Kaushal M. Bhavsar (MBBS, MD)Assistant Professor in Pulmonary Medicine, GMERS Medical College, Ahmedabad