A prostatic specific antigen is a substance in the blood of a man. Its concentration may vary depending on what changes are in the state of the prostate. The analysis is usually used not only to detect prostate cancer, but also to evaluate the effectiveness of the treatment in relation to this disease.
A blood test has two varieties:
- PSA is common;
- PSA is free.
As a rule, the doctor gives an appointment for the first. Much less often, in order to clarify the diagnosis, it is necessary to determine free PSA as well. The common norm for all is an indicator from zero to four ng per milligram. But for forty-year-old men, a certain value of PSA analysis is recommended. Norm - no more than two and a half, and for fifty-year-olds - no more than three and a half.
Why is PSA analysis increased overall?
Firstly, a significant or even insignificant change in the indicator occurs due to inflammation due to prostatitis, or due to the presence of benign prostatic hyperplasia (adenoma).
Secondly, a temporary increase in the overall PSA analysis indicators may be associated with a mechanical effect on the prostate (massage, biopsy, cystoscopy, catheterization, and so on).
Thirdly, greater severity and stability with increased analysis is observed with prostate cancer.
Rules that must be followed when PSA is shared:
- You can not take it immediately after eating, it is better to do it on an empty stomach.
- It is recommended to perform two weeks after mechanical action (massage of the prostate, cystoscopy or catheterization of the bladder), and after a biopsy of the prostate only after a month.
- The doctor must be informed about which medications were taken, as well as the presence of previously diagnosed prostate diseases (prostatitis and adenoma).
Often there are situations when there is a need to do additional analysis - free. The doctor gives a referral to him when the total PSA varies in parameters from four to ten ng per milligram and there are doubts that a prostate biopsy is necessary . Because with an indicator of more than ten ng per milligram, free PSA is not given for analysis, and the patient is immediately sent for a biopsy.
It is necessary to keep in mind the following exceptions to the basic regularity.
Firstly, there is a chance that there is prostate cancer even when the total PSA has an indicator below four points. Usually he is diagnosed by a doctor when there is a seal in the prostate, determined only through the rectum in a man who is over fifty years old.
Secondly, there is an increase in the total PSA indicator, and there are seals in the prostate. But this is not always an absolute sign that there is cancer.
Thirdly, situations when the total PSA is high and the biopsy does not show the presence of prostate cancer are quite common. The fact is that the last analysis does not always reveal the presence of a small tumor. Therefore, after three months, it is imperative to do a second biopsy. Moreover, it’s not usual, but only using ultrasonic guidance, which will allow you to "point" the tool to the desired area more accurately than a regular finger. In this case, a combination of indicators (PSA general and special biopsy) is very accurate in the diagnosis of prostate cancer.
Fourthly, when prescribing hormonal treatment for metastatic prostate cancer, a control section is recommended, that is, PSA total at least once every three months.
Naturally, such nuances must be taken into account in the process of diagnosis and treatment of any prostate diseases.
Be healthy!