What Does a PSA Test Do and Why Is It Controversial

 Prostate specific antigen or PSA for short is a protein produced in men by the prostate gland. This protein helps fertility as it provides nourishment for sperm it and aids its movement. A small amount of the protein leaks naturally into the bloodstream. If desired this can be detected by a blood test called a PSA test.

The prostate specific antigen test involves taking a small sample of blood from a vein and then it is analysed in a laboratory.

A higher than usual amount of the marker in the blood suggests that 'something' is happening in the prostate gland. This something is not necessarily cancer. Levels may be elevated though an infection of the prostate for instance.

It is important to comprehend PSA levels do generally correlate with the risk of prostate cancer, nor, the risk of aggressive prostate cancer. A test performed once a year provides useful information about the rate of change in levels which in practice is very helpful. A single raised level should be double checked with the patient advised not to ejaculate for 48 hours before the test as this can elevate levels as can vigorous exercise especially cycling.

Is a good or bad thing to test?

There is presently much debate about whether routine PSA screening is a good or a bad thing and there remains there is considerable controversy about the merits of these tests and prostate screening in general.

For many men in their later middle years it might seem that such a test is a sensible thing to do. The assay is after all a widely used screening test for men over 40 and as it simply measures a protein in the blood that often spikes when prostate cancer is present it is of no harm. Therefore, it would seem a sensible precaution to have a regular test perhaps once a year or so. Indeed this is what many doctors recommend but there are also many who don't.

On the one hand are the camp who point out that deaths due to this cancer have fallen considerably since screening was introduced - approximately 40% - but on the other side is an argument to say that it is a flawed test which contributed to an upsurge of anxiety, unnecessary surgery medical intervention and overtreatment.

While the debate rages on it's probably best to view a PSA test as indicator that there is something a foot with the prostate which requires further investigation, but is not necessarily sinister or life threatening.