Prostate-Specific Antigen (PSA), Total Biomarker Test Guide

What is the Prostate-Specific Antigen (PSA), Total Biomarker Test?

The Prostate-Specific Antigen (PSA), Total biomarker test measures the total amount of PSA in the bloodstream. PSA is a protein produced by the cells of the prostate gland and is typically present in small amounts. This test looks at both free PSA (not bound to proteins) and bound PSA (attached to proteins) to provide a total value.

An elevated total PSA level can be a sign of various prostate conditions, such as benign prostatic hyperplasia (BPH), prostatitis, or prostate cancer. PSA, Total tests are widely used in prostate cancer screening, as well as for monitoring prostate health and treatment effectiveness in men diagnosed with prostate-related conditions.

Why Should You Get a PSA, Total Biomarker Test?

You may be advised to get a PSA, Total test for several reasons:

Prostate Cancer Screening: Elevated PSA levels can be an early indicator of prostate cancer. Routine testing is recommended for men over the age of 50, or earlier for those with family history or other risk factors.
Prostate Health Monitoring: For men with BPH (enlarged prostate) or prostatitis, the PSA, Total test is used to monitor the progression of these conditions and assess the effectiveness of treatments.
Post-Prostate Cancer Treatment Monitoring: After prostate cancer treatment, PSA tests are crucial to monitor for cancer recurrence. A rise in PSA levels after surgery or radiation may indicate a return of cancer.
Urinary or Prostate Symptoms: If you experience symptoms like difficulty urinating, frequent urination, or pain in the pelvic region, your healthcare provider may order a PSA, Total test to help identify the cause of these symptoms.

Normal Ranges for PSA, Total Levels

The normal range for PSA levels can vary based on age and race. Below are the general reference ranges for PSA, Total levels measured in nanograms per milliliter (ng/mL):

Men aged 40-49: less than 2.5 ng/mL
Men aged 50-59: less than 3.5 ng/mL
Men aged 60-69: less than 4.5 ng/mL
Men aged 70 and older: less than 6.5 ng/mL

Elevated PSA levels do not always indicate prostate cancer. Benign conditions such as BPH, prostatitis, and even recent activities like ejaculation, cycling, or a prostate exam can cause temporary increases in PSA levels. However, persistently elevated levels may require further testing to rule out cancer.

Health Symptoms Related to Elevated PSA Levels

Elevated PSA levels can indicate underlying prostate issues, which may present with the following symptoms:

Difficulty starting or stopping urination.
Frequent urination, especially at night (nocturia).
Weak or interrupted urine flow.
Pain during urination or ejaculation.
Blood in the urine (hematuria) or semen.
Pelvic pain, lower back pain, or discomfort in the hips and legs.

These symptoms may point to prostate conditions like BPH, prostatitis, or even prostate cancer. While these symptoms are not exclusive to cancer, they warrant further investigation and testing.

Health Professionals Who Can Use PSA, Total Test Results

The results of a PSA, Total test are valuable for several healthcare professionals:

Urologists: Specialists in male reproductive health and urinary tract disorders. Urologists often use PSA test results to diagnose, monitor, and treat prostate conditions like BPH, prostatitis, or prostate cancer.
Oncologists: If prostate cancer is suspected or confirmed, oncologists will utilize PSA, Total results to determine the stage of the cancer and guide treatment strategies such as radiation therapy, surgery, or hormonal therapy.
Primary Care Physicians (PCPs): PCPs may include the PSA, Total test as part of routine checkups for men over a certain age or for those presenting with symptoms of prostate issues.
Geriatricians: Specialists in the care of older adults may recommend PSA testing for older men to monitor prostate health, especially since the risk of prostate cancer increases with age.

How Often Should You Take the PSA, Total Test?

The frequency of PSA testing depends on individual risk factors and your healthcare provider’s recommendations:

Routine Screening:
- Men over 50: Annual or biennial PSA tests are often recommended for prostate cancer screening.
- Men at higher risk: Those with a family history of prostate cancer or African American men may begin testing earlier, around age 40-45.
Monitoring Prostate Conditions:
- If you have BPH or prostatitis, your doctor may recommend regular PSA tests (every 6-12 months) to monitor the condition and adjust treatments if necessary.
After Prostate Cancer Treatment:
- PSA tests are critical after prostate cancer treatment, especially during the first few years post-treatment. PSA tests may be recommended every 3-6 months to detect any signs of cancer recurrence.

What’s the Next Step After Testing?

The next step after receiving PSA, Total test results depends on the PSA level:

Normal PSA Levels:
- If your PSA level falls within the normal range for your age group, your healthcare provider may recommend continuing with routine screenings based on your risk factors.
Elevated PSA Levels:
- If your PSA levels are elevated, additional tests may be ordered, such as:
  - A repeat PSA test (to confirm the result).
  - A digital rectal exam (DRE) to check for prostate abnormalities.
  - Prostate imaging such as ultrasound or MRI.
Further Diagnostic Testing:
- If there is concern for prostate cancer, a prostate biopsy may be recommended to obtain tissue samples for examination.
Lifestyle Modifications:
- If elevated PSA levels are due to benign conditions like BPH or prostatitis, your doctor may recommend lifestyle changes or medications to help manage the condition and reduce PSA levels.
Cancer Treatment:
- If prostate cancer is detected, treatment options such as active surveillance, surgery, radiation therapy, or hormone therapy may be considered, depending on the stage and aggressiveness of the cancer.

Prostate-Specific Antigen (PSA), Total Biomarker Test Guide