Inside the PSA Test

95% of all prostate cancers are adenocarcinoma, literally translated "cancer of a gland." It is usually slow growing, giving men who have it a chance to catch it early if they are screened. Unfortunately, one of the ways of screening for this cancer is invasive and unpleasant. That's called the digital rectal exam.

There is some good, if controversial news about screenings for this disease. The PSA (prostate-specific antigen test may also be helpful in early detection of prostate adenocarcinoma. This test is relatively new, and still needs some tweaking. It can deliver both false positive and false negative results. Neither the PSA nor the DRE are 100% accurate, but it's enough to cause a steep decline in deaths from this disease.

Before continuing with information on the PSA test, let me mention two other forms this disease can take. Small cell and squamous cell carcinoma cannot be detected by the blood test, and they are very aggressive cancers. Until something similar can be developed, DRE is going to be the only way to screen for these manifestations.

Here are a few stats on this medical condition. It is extremely rare in men under forty, and most of those who are diagnosed are older than sixty-five. It is slow growing, and in some men it may never cause any noticeable symptoms. Men with the disease have died of other problems long before symptoms set in.

PSA is found mostly in semen, but a small amount is found naturally in blood. Most men have levels under 4 ng/ml (nanograms per milliliter). Most of the time, they are cancer free, but it is possible to have the disease with levels under that amount.

The American Cancer Society has some recommendations for men about using the PSA tests, based on the above facts. They recommend that you receive a complete list of the benefits and risks associated with this screening. It's important to discuss with your doctor the pros and cons.
If you are African-American or you have a close relative who has had this disease prior to age sixty-five, you are considered at high risk. The relatives to pay attention to are your father, your brothers or your sons. If you have several such relatives who've had the diagnosis, you are at an even greater risk.

Once you've been tested, it's time to look at the numbers. Any number less than 2.5 ng/ml suggests retesting in two years. Over that amount suggests retesting yearly. Because many of the men who have higher levels are older, the recommendation is that if life expectancy is less than ten years, testing should not occur.

Don't panic if you hear that your numbers are higher than that above. Several factors can cause them to rise that do not include cancer. BPH (benign prostate hypoplasia), inflammation and age can increase the markers. So can having sex, so you should abstain from doing so for two days prior to testing. After that, they should return to normal.

Science is working towards improving this test and finding others that can help you live a long and healthy life. A yearly visit to the doctor may not be comfortable, but catching diseases early can help you fulfill that goal.