What Do The Results Mean
High PSA levels can mean cancer or a noncancerous condition such as a prostate infection, which can be treated with antibiotics. If your PSA levels are higher than normal, your health care provider will probably order more tests, including:
- A rectal exam. For this test, your health care provider will insert a gloved finger into your rectum to feel your prostate.
- A biopsy. This is a minor surgical procedure, where a provider will take a small sample of prostate cells for testing.
If you have questions about your results, talk to your health care provider.
Learn more about laboratory tests, reference ranges, and understanding results.
What Are Some Tips For Fasting Before Psa Blood Testing
Unless specifically requested by a doctor, fasting is typically not required prior to a prostate-specific antigen, or PSA, blood test, according to Lab Tests Online. If fasting is required, patients must consume no food or drinks, except water, for a time period prior to the lab test, explains Quest Diagnostics.
Because its easier to draw blood from people who are adequately hydrated, its important to drink plenty of water while fasting prior to a blood test, according to Quest Diagnostics. Patients should continue taking all medications during the fasting period, unless otherwise directed by a doctor. When fasting is required, its best to schedule the blood test first thing in the morning to minimize the amount of time without food. If desired, patients may bring a snack with them to eat after the blood test is complete.
Although patients usually dont need to fast before a PSA blood test, other preparation is required, according to Lab Tests Online. Because ejaculation sometimes raises PSA levels, its best for patients to avoid ejaculating for 24 hours prior to the blood test. Patients should have a PSA test done before a doctor performs a digital rectal exam and before a prostate biopsy. Patients with a recent prostate biopsy should wait several weeks before having a PSA blood test.
Not All Men Need The Test But If You Do Here’s How To Do It Right
The PSA test for prostate cancer is surprisingly controversial. Many experts, in fact, now recommend against the test for most men, saying that the cancers it detects are often relatively harmless tumors that would never progress beyond the gland, and that treatment, usually with surgery or radiation, can be more dangerous and debilitating than the disease itself.
Still, many men concerned about cancer still opt for the PSA test. And some men already diagnosed with the cancer need periodic tests to track the progress of the disease.
In those cases, it’s important to make sure that the test is as accurate as possible. Here’s what you need to do.
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What Is A Psa Test
Prostate-specific antigen is a protein produced by the prostate gland that is present in small quantities in all men’s blood. It often is elevated in the presence of prostate cancer, making a man’s PSA levels a useful tool for early prostate cancer detection.
The PSA blood test was developed at Roswell Park Comprehensive Cancer Center in the 1970s and is now in use worldwide. Since the test was first introduced, the cure rate for prostate cancer has increased from about 4% to 80%. Here are some answers to the frequently asked questions we receive from men preparing for their first PSA exam.
How Are Researchers Trying To Improve The Psa Test
Scientists are investigating ways to improve the PSA test to give doctors the ability to better distinguish cancerous from benign conditions and slow-growing cancers from fast-growing, potentially lethal cancers. None has been proven to decrease the risk of death from prostate cancer. Some of the methods being studied include:
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Getting A Prostate Biopsy
For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope. This test is the only way to know for sure if a man has prostate cancer. If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly.
For more details on the prostate biopsy and how it is done, see Tests to Diagnose and Stage Prostate Cancer.
For more information about the possible results of a prostate biopsy, see the Prostate Pathology section of our website.
What Is The Psa Screening Controversy
The goal of measuring PSA in men with no symptoms of cancer as a screening test for prostate cancer is to reduce the mortality caused by this cancer. Although the advent of prostate cancer screening is associated with decreased prostate cancer deaths, concerns exist regarding risks of overtreatment and the associated risks of such treatments.
A substantial number of the cancers detected by PSA screening are early stage and low-risk, and these patients will likely never die from this disease. PSA screening, due to its low specificity, does not allow differentiating between low-risk and high-risk prostate cancer. Hence PSA systematic screening is inevitably associated with over-diagnosis and potentially overtreatment. Therefore, not only do these patients not benefit from early detection but they also carry the burden of a cancer diagnosis. In addition, a subset of these patients may suffer the side effects of an unnecessary treatment.
Another trial conducted in the United States recently concluded that there is no evidence of an improvement in death rate from prostate cancer with annual PSA screening compared with usual medical care. After 13 years of follow-up, the cumulative mortality rates from prostate cancer in the intervention and control groups were 3.7 and 3.4 deaths per 10,000 person-years, respectively, meaning that there was no significant difference between the two groups.
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Questions To Ask Your Doctor
You and your physician share the responsibility of deciding what is best for your health. Having an informed discussion with your doctor about your prostate health leads to better treatment decisions. Here are some questions that can help begin this discussion.
- How accurate is PSA in detecting aggressive prostate cancer?
- What percentage of patients with an elevated PSA have prostate cancer?
- Is there any risk if I decide to first take the 4Kscore Test to see what information we learn before committing for a biopsy?
- What percentage of patients with positive biopsies are positive for aggressive prostate cancer?
- If I am diagnosed with the indolent form of prostate cancer, is treatment recommended?
- What percentage of your biopsies are negative or detect a low-grade indolent prostate cancer for which no treatment is recommended?
- What are the alternatives to a prostate biopsy?
- Do you have the ability to draw a blood sample for the 4Kscore Test or suggest a nearby 4Kscore test center?
What Are Psa Tests
Prostate-specific antigen is a protein made by a man’s prostate gland .
PSA tests are used to measure the level of PSA in a man’s blood. A raised level of PSA can be a sign of a prostate condition, such as:
Before having a PSA test, men should not have ejaculated during the previous 48 hours.
Semen released during sexual activity can cause PSA levels to rise temporarily, which may affect the test results.
For the same reason, before having a PSA test men should not have:
- exercised vigorously in the previous 48 hours
- an active urinary infection
- had a prostate biopsy in the previous 6 weeks
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How Is A Psa Test Administered
A sample of your blood will be sent to a laboratory for further examination. To withdraw blood from an artery or vein, a healthcare provider will usually insert a needle into the inside of your elbow. You may feel a sharp, piercing pain or slight sting as the needle is inserted into your vein.
Once theyve collected enough blood for the sample, they will remove the needle and hold pressure on the area to stop the bleeding. Theyll then put an adhesive bandage over the insertion site in case you bleed more.
Your blood sample will be sent to a laboratory for testing and analysis. Ask your doctor if theyll follow up with you regarding your results, or if you should make an appointment to come in and discuss your results.
A PSA test can also be done with an at-home testing kit. You can purchase a test kit online from LetsGetChecked here.
How To Get Tested
Samples used for PSA testing are collected by trained health care professionals at hospitals, labs, and other medical settings. Before getting tested, its best to talk to your doctor about the risks and benefits of PSA testing. You may be able to schedule your own PSA test at a clinic or laboratory without a doctors order. However, you will need a doctor to interpret the results of your test and recommend next steps.
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What Happens If You Dont Fast Before Blood Test
Not fasting for a blood test will yield inaccurate results. As mentioned above, as the food is digested and metabolized, the nutrients which enter the bloodstream can interfere with test results.
If you happen to accidentally eat or drink something before a blood test, make sure to inform your clinician about it. In this case, both the clinician makes a note of it and test results are analyzed accordingly or you for better results, an appointment for the blood tests may need to be rescheduled.
Do I Need The Psa Test
The PSA test is not recommended for men who dont have symptoms of prostate cancer, as it can lead to unnecessary investigations and treatments that have serious side effects.
If you are at higher risk of developing prostate cancer, or if you have symptoms that may indicate cancer, PSA testing may be of more benefit.
Cancer Council Australia and the Royal Australian College of General Practitioners both recommend against routine screening in men without symptoms. That is because the PSA test is not very accurate for screening men without symptoms. High PSA levels can be due to many things, and cancer is just one of them. And a man with prostate cancer can have a normal PSA level.
As there is a range of risks and potential benefits of PSA testing, talk to your doctor to help make an informed decision.
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What Is A Normal Psa Test Result
There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.
However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer . In addition, various factors can cause a mans PSA level to fluctuate. For example, a mans PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugsincluding finasteride and dutasteride , which are used to treat BPHlower a mans PSA level. PSA level may also vary somewhat across testing laboratories.
Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of White men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.
In general, however, the higher a mans PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a mans PSA level over time may also be a sign of prostate cancer.
I’ve Been Asked To Have A Psa Test What Should I Do
If you have been requested by the Doctor or Nurse to have a PSA test, you will need to ask at reception to book a non-fasting blood test. Blood tests normally take 5-10 minutes. We advise patients to drink water prior to testing as it will keep you hydrated and help raise the veins when the phlebotomist needs to take a sample. You must bring with you on appointment your blood test form.
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Key Takeaway For Future Testosterone Testing Protocols
The scientific literature on sexual medicine mentions that food intake might affect testosterone levels. However, the standard testing protocol doesn’t incorporate fasting before a test. The results of the studies above pave the way to a potentially important change in how testosterone tests are done.
Furthermore, there were no significant differences in LH, SHBG, and other hormones among the study participants. This reveals that the behavior of the Hypothalamic-Pituitary-Testicular axis wasn’t really affected by food or glucose intake, but testosterone production was. It is believed that insulin, a hormone produced by the pancreas when we eat to process glucose, may decrease testosterone production temporarily at the testicular level.
If you think that you have low testosterone, check out these testosterone tests that you can order online at an affordable price and see how your hormones are doing.
References:
Testosterone decrease after a mixed meal in healthy men independent of SHBG and gonadotropin levels. Andrologia. Volume 44, Issue 6 December 2012. Pages 405-410.
Abrupt decrease in serum testosterone levels after an oral glucose load in men: implications for screening for hypogonadism. Clin Endocrinol 2013 Feb 78:291-6.
Factors That Might Affect Psa Levels
One reason its hard to use a set cutoff point with the PSA test when looking for prostate cancer is that a number of factors other than cancer can also affect PSA levels.
Factors that might raise PSA levels include:
- An enlarged prostate: Conditions such as benign prostatic hyperplasia, a non-cancerous enlargement of the prostate that affects many men as they grow older, can raise PSA levels.
- Older age: PSA levels normally go up slowly as you get older, even if you have no prostate abnormality.
- Prostatitis: This is an infection or inflammation of the prostate gland, which can raise PSA levels.
- Ejaculation: Thiscan make the PSA go up for a short time. This is why some doctors suggest that men abstain from ejaculation for a day or two before testing.
- Riding a bicycle: Some studies have suggested that cycling may raise PSA levels for a short time , although not all studies have found this.
- Certain urologic procedures: Some procedures done in a doctors office that affect the prostate, such as a prostate biopsy or cystoscopy, can raise PSA levels for a short time. Some studies have suggested that a digital rectal exam might raise PSA levels slightly, although other studies have not found this. Still, if both a PSA test and a DRE are being done during a doctor visit, some doctors advise having the blood drawn for the PSA before having the DRE, just in case.
- Certain medicines: Taking male hormones like testosterone may cause a rise in PSA.
Some things might lower PSA levels :
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What Is Being Tested
The PSA blood test can help detect or monitor prostate cancer.
The prostate is a small gland at the base of the bladder in men. It is part of the male reproductive system, and produces the protein PSA. PSA is released into semen but some also enters the bloodstream.
High levels of PSA can be caused by prostate cancer, but they are usually caused by other conditions.
If you have prostate symptoms, you might be asked to have a PSA test. It might help point your doctor in certain directions, but it doesnt diagnose prostate cancer. The only way to do that is with a biopsy.
If you have been diagnosed with prostate cancer, the PSA test can help monitor your condition. When the levels go up, this suggests the cancer is growing. When they go down, this suggests it might be shrinking.
Psa Blood Test Fasting
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How To Prepare For The Test
The PSA test is meant to check for prostate cancer by measuring the prostate-specific antigen , a protein often elevated in men with prostate cancer.
But only about 25 percent of men with mild and moderate elevations might actually have prostate cancer. Instead, those high levels could be due to problems such as an enlarged prostate gland , a prostate infection, recent sexual activity, or even a recent long bike ride, says Scott Eggener, M.D., co-director of the prostate cancer program at the University of Chicago.
These steps can make sure that the results are as accurate as possible:
Wait after a urinary tract infection. If youve had a recent UTI or catheter, hold off on the test for a few months. Both can cause prostate inflammation that can artificially elevate PSA levels.
Abstain from sex. Ejaculation up to 72 hours before the test could raise PSA levels a minimal amount.
Have the digital rectal exam after the blood test. As part of a prostate-cancer exam, your doctor may perform this test, which is used to check the size of the prostate gland and to look for abnormal bumps or other changes. But if you do it before having the PSA test, it could cause the release of PSA into the bloodstream and possibly lead to a false positive result.
