PSA testing

By regularly testing PSA it's possible to detect early‑stage asymptomatic prostate cancer. The specialists at Docrates recommend that men of 50 to 75 years of age have their PSA level checked each year in a PSA testing.

What is a PSA test and when should it be done?

By regularly testing PSA it’s possible to detect early‑stage asymptomatic prostate cancer. PSA (prostate-specific antigen) is a protein produced by the prostate. Its level in the blood typically increase in prostate cancer and benign prostatic hyperplasia. PSA level can be determined with a simple blood test.

The specialists at Docrates recommend that men of 50 to 75 years of age have their PSA level checked each year in a PSA testing. If close relatives have been diagnosed with cancer, monitoring and testing should begin even earlier. Regular PSA testing helps to assess the cancer risk and the need for any further examinations. Sometimes PCA3 determination can provide additional information.

Even quite low PSA levels can indicate cancer

The significance of the PSA level should always be assessed in proportion to the size of the prostate. The larger the prostate, the higher the PSA level. Even quite low PSA levels can indicate cancer. The level of free PSA is significant in differential diagnostics when assessing benign and malignant lesions. The lower the free PSA level, the higher the risk of cancer. The following table shows the reference values for total PSA in different age groups and the relationship between the percentage of free PSA and cancer risk.

The table below is intended as a rule of thumb for the assessment.

Reference values for PSA

Age (yrs)

S-PSA ( µg/l )

40-49

less than 2,5

50-59

less than 3,5

60-69

less than 4,5

70-79

less than 6,5

Proportion of free PSA (%)

Cancer risk (%)

0-10

56

10-15

28

15-20

20

20-25

18

over 25

8

 

(Sources: Thompson et al.: Prevalence of prostate cancer among men with a prostate-specific antigen level < or = 4.0 ng per milliliter, New England Journal of Medicine, 2004, May 27, and Finnish Current Care guidelines)

When assessing the whole process, a specialist’s appointment is always a significant part of examinations

PSA test results are not always unambiguous. A total PSA value that is higher than reference values does not always suggest the presence of cancer, while on the other hand, a low PSA level does not exclude the probability of cancer. Therefore, when assessing the entire process, a specialist’s appointment is always an important part of examinations.

At Docrates, a prostate cancer specialist will assess your case thoroughly. Information that will be gone through in the specialist’s office include your medication, general health, previous examinations and treatments, as well as previous laboratory examinations and symptom questionnaires. In addition, the specialist will perform a rectal examination and subsequently a potential ultrasound test of the prostate gland.

If necessary, the physician can prescribe further examinations. Such tests include for example a Stockholm3 (STHLM3) test and/or an MRI-guided robotic prostate biopsy. Our specialists are experts in these questions, and they are used to solving various problems associated with prostate symptoms and cancer suspicions together with patients.

Prostate cancer experts at Docrates help if your PSA values are elevated or fluctuating

At Docrates Cancer Center, frontline experts will give you comprehensive answers to your questions about prostate cancer. Whether it be a question of prostate symptoms, cancer suspicions or the treatment of already diagnosed prostate cancer, you will receive comprehensive information, with a focus on your individual situation, as well as specific recommendations for the next phase. At Docrates you will not be left alone, but we will discuss together, which treatment options would work best especially for you.

How to prepare for PSA test?

It is not necessary to avoid eating prior to the test. Before having a PSA test you should not have ejaculated nor exercised vigorously (for ex. cycling) during the previous 48 hours.

At Docrates Cancer Center, PSA tests are available in our laboratory without a referral or an advance booking from Monday to Friday  8 am-2 pm. Address: Saukonpaadenranta 2, 00180 Helsinki, Finland.

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