What Are The Risks Of Having A Psa Test
Often the PSA test can show high levels of PSA that aren’t caused by cancer .
If your PSA test is high, you may need more testsâlike a prostate biopsyâto check for prostate cancer. These tests can be harmful. For example, prostate biopsies can cause infections. For a few men, these infections are very serious. These tests can also cause a lot of worry.
PSA tests may miss some cancers. Not all prostate cancers cause a high PSA, so some PSA tests will be normal when there is cancer . But the more serious prostate cancers usually do cause a high PSA.
A PSA test can find cancers that would not have caused a problem . You might have this type of cancer, but a PSA test can’t tell if the cancer is harmless. So you may get cancer treatmentâincluding surgery or radiationâthat you don’t need.
Controversy About The Psa Test
PSA tests are controversial because doctors and experts arent sure if the benefits of early detection outweigh the risks of misdiagnosis. Its also not clear if the screening test actually saves lives.
Because the test is very sensitive and can detect increased PSA numbers at low concentrations, it may detect cancer thats so small it would never become life-threatening. Just the same, most primary care physicians and urologists do choose to order the PSA as a screening test in men over the age of 50.
This is called overdiagnosis. More men may face complications and risks of side effects from the treatment of a small growth than they would if their cancer was left undiagnosed.
Its doubtful those small cancers would ever cause major symptoms and complications because prostate cancer, in most but not all cases, is a very slow-growing cancer.
Theres also no specific level of PSA thats considered normal for all men. In the past, doctors considered a PSA level of 4.0 nanograms per milliliter or lower to be normal, reports the National Cancer Institute.
However, recent research has shown that some men with lower levels of PSA have prostate cancer and many men with higher levels of PSA dont have cancer. Prostatitis, urinary tract infections, certain medications, and other factors can also cause your PSA levels to fluctuate.
All men are at risk of prostate cancer, but a few populations are more likely to develop it. These include:
What Is A Prostate
A prostate-specific antigen test measures the level of PSA in your blood. The prostate is a small gland that is part of a man’s reproductive system. It is located below the bladder and makes a fluid that is part of semen. PSA is a substance made by the prostate. Men normally have low PSA levels in their blood. A high PSA level may be a sign of prostate cancer, the most common non-skin cancer affecting American men. But high PSA levels can also mean noncancerous prostate conditions, such as infection or benign prostatic hyperplasia, a noncancerous enlargement of the prostate.
Other names: total PSA, free PSA
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When Is A Psa Test Needed
If you are age 50 to 74, you should discuss the PSA test with your doctor. Ask about the possible risks and benefits.
Men under 50 or over 75 rarely need a PSA test, unless they have a high risk for prostate cancer.
- You are more likely to get prostate cancer if you have a family history of prostate cancer, especially in a close relative such as a parent or sibling.
- Your risks are higher if your relative got prostate cancer before age 60 or died from it before age 75. These early cancers are more likely to grow faster.
- If you have these risks, you may want to ask your doctor about getting the PSA test before age 50.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
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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Can I Take The Test At Home
Although testing for PSA at home is uncommon, several at-home PSA tests are available. At-home PSA tests typically involve collecting samples of blood at home through a fingerstick and sending the samples into a laboratory for testing. When considering at-home PSA testing, its important to understand the potential harms of this test.
At-home testing may be less accurate than testing a sample taken from a vein. PSA testing can also show a higher result when cancer isnt present and can lead to additional diagnostic procedures. Because the role of PSA testing is highly individualized, its important to seek testing only under the care and guidance of a doctor.
What Research Has Been Done To Study Prostate Cancer Screening
Several randomized clinical trials;of prostate cancer screening have been carried out. One of the largest is the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which NCI conducted to determine whether certain screening tests can help reduce the numbers of deaths from several common cancers. In the prostate portion of the trial, the PSA test and DRE were evaluated for their ability to decrease a mans chances of dying from prostate cancer.
The PLCO investigators found that men who underwent annual prostate cancer screening had a higher incidence of prostate cancer than men in the control group but the same rate of deaths from the disease . Overall, the results suggest that many men were treated for prostate cancers that would not have been detected in their lifetime without screening. Consequently, these men were exposed unnecessarily to the potential harms of treatment.
A second large trial, the European Randomized Study of Screening for Prostate Cancer , compared prostate cancer deaths in men randomly assigned to PSA-based screening or no screening. As in the PLCO, men in ERSPC who were screened for prostate cancer had a higher incidence of the disease than control men. In contrast to the PLCO, however, men who were screened had a lower rate of death from prostate cancer .
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What Is The Psa Test
Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in a mans blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter of blood.
The blood level of PSA is often elevated in men with prostate cancer, and the PSA test was originally approved by the US Food and Drug Administration ;in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994,;FDA approved the use of the PSA test in conjunction with a digital rectal exam to test asymptomatic men for prostate cancer. Men who report prostate symptoms often undergo PSA testing to help doctors determine the nature of the problem.
In addition to prostate cancer, a number of benign conditions can cause a mans PSA level to rise. The most frequent benign prostate conditions that cause an elevation in PSA level are prostatitis and benign prostatic hyperplasia ;. There is no evidence that prostatitis or BPH leads to prostate cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.
Why Do I Need A Psa Test
You may get a PSA test if you have certain risk factors for prostate cancer. These include:
- A father or brother with prostate cancer
- Being African-American. Prostate cancer is more common in African American men. The reason for this is unknown.
- Your age. Prostate cancer is more common in men over the age of 50.
You may also get a PSA test if:
- You have symptoms such as painful or frequent urination, and pelvic and/or back pain.
- You’ve already been diagnosed with prostate cancer. The PSA test can help monitor the effects of your treatment.
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What Makes The Imaware Psa Test Unique
While we use the same total PSA biomarker that other tests use, our at-home imawareâ¢ PSA test is unique as it can be done in the comfort of your own home. It can also be ordered without a physicianâs note, as imawareâ¢ has a team of physicians that approve all orders and results for patients. Your PSA test results are delivered to a secure patient portal and are easy to download for your next doctor appointment. Getting a PSA test is easy with imawareâ¢.
What Are The Risks And Potential Complications Of Psa Testing
The health risks of PSA testing are minimal. The more important concerns with PSA testing lie in interpreting its results. The main concerns and limitations of PSA testing include:
False-positive results. Because there is no standardized range for normal PSA levels, a mans test result could show elevated PSA levels even though he does not have prostate cancer. False-positive PSA results can cause concern and lead to unnecessary prostate biopsies.
False-negative results. Some men with prostate exhibit normal levels of prostate-specific antigen in their blood. A normal PSA finding can leave those men with a false sense of security about their health status.
Test results that lead to overtreatment. A positive PSA result might indicate only that a man has a small malignant tumor within the prostatetumors that tend to grow very slowly and are rarely fatal. Observation is often recommended in this situation. Overtreating smaller, nonaggressive tumors by subjecting men to invasive treatments, such as , with significant potential complications may not prolong their lives and could cause unnecessary harm.
PSA testing is a personal health decision. Talk with your doctor about your risk of prostate cancer and the use of PSA screening as part of your annual physical.
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Results Of A Psa Blood Test
With imawareâ¢, youâll receive your results within 7 days of shipping the sample off to our labs. Youâll receive an email prompting you to log into your secure patient portal to view your results. Your results will give you a detailed look at your total PSA biomarker. Not only will the results give you a numerical value, but also a qualitative look into your data, taking into account any provided risk factors.
Screening Tests For Prostate Cancer
Screening is testing to find cancer in people before they have symptoms. Its not clear, however, if the benefits of prostate cancer screening outweigh the risks for most men. Still, after discussing the pros and cons of screening with their doctors, some men might reasonably choose to be screened.
The screening tests discussed here are used to look for possible signs of prostate cancer. But these tests cant tell for sure if you have cancer. If the result of one of these tests is abnormal, you will probably need a prostate biopsy to know for sure if you have cancer.
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New And Upcoming Tests For Prostate Cancer
The good news about new and upcoming tests for prostate cancer is that they can tell you more specific information than the PSA test alone.
You and your doctor can use the new urine test for prostate cancer to let you know if you have low-risk or high-risk prostate cancer, and this can help you make more-informed decisions about further testing and treatment. Also, a new genetic test that predicts prostate canceris on the way.
This, too, will allow doctors and patients to learn more about how aggressive their tumors are so they can make the right treatment decisions for them.
Talk to your doctor about your risk factors for prostate cancer. Knowing your risk factors along with your PSA level are some of the first steps in getting on track with your prostate health. Just be sure that you avoid doing any of the activities that can affect your PSA level for the 48 hours leading up to your test, and be aware of the other factors that can affect your PSA.
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What Is It Used For
A PSA test is used to screen for prostate cancer. Screening is a test that looks for a disease, such as cancer, in its early stages, when it’s most treatable. Leading health organizations, such as the American Cancer Society and the Centers for Disease Control and Prevention , disagree on recommendations for using the PSA test for cancer screening. Reasons for disagreement include:
- Most types of prostate cancer grow very slowly. It can take decades before any symptoms show up.
- Treatment of slow-growing prostate cancer is often unnecessary. Many men with the disease live long, healthy lives without ever knowing they had cancer.
- Treatment can cause major side effects, including erectile dysfunction and urinary incontinence.
- Fast-growing prostate cancer is less common, but more serious and often life-threatening. Age, family history, and other factors can put you at higher risk. But the PSA test alone can’t tell the difference between slow- and fast-growing prostate cancer.
To find out if PSA testing is right for you, talk to your health care provider.
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What About Fasting For A Blood Test During Pregnancy
There are several blood tests you may need if youre pregnant. These are designed to assess any potential health concerns that you or your baby might experience during pregnancy or after you give birth. Some of these tests will require you to fast beforehand. Your doctor will advise you how to prepare for each test.
Fasting is usually safe if youre pregnant, provided youre in good health and arent having a high-risk pregnancy. For your overall comfort, your doctor may advise you to drink extra water or to remain indoors, especially if the weather is very hot or humid.
Fasting may increase heartburn in some pregnant women. If you experience uncomfortable or concerning symptoms of any kind while youre waiting to have your blood drawn, let your doctor know immediately.
If youre seeing a doctor other than your obstetrician-gynecologist, make sure they are made aware of your pregnancy before your blood test.
What If A Screening Test Shows An Elevated Psa Level
If a man who has no symptoms of prostate cancer chooses to undergo prostate cancer screening and is found to have an elevated PSA level, the doctor may recommend another PSA test to confirm the original finding. If the PSA level is still high, the doctor may recommend that the man continue with PSA tests and DREs at regular intervals to watch for any changes over time.
If a mans PSA level continues to rise or if a suspicious lump is detected during a DRE, the doctor may recommend additional tests to determine the nature of the problem. A urine test may be recommended to check for a urinary tract infection. The doctor may also recommend imaging tests, such as a transrectal ultrasound, x-rays, or cystoscopy.
If prostate cancer is suspected, the doctor will recommend a prostate biopsy. During this procedure, multiple samples of prostate tissue are collected by inserting hollow needles into the prostate and then withdrawing them. Most often, the needles are inserted through the wall of the rectum . A pathologist then examines the collected tissue under a microscope. The doctor may use ultrasound to view the prostate during the biopsy, but ultrasound cannot be used alone to diagnose prostate cancer.
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What Are The Risk Factors For Prostate Cancer
There are several factors that increase the risk of developing prostate cancer:
- Age: Prostate cancer increases with age after age 50, and the majority of cancers are diagnosed after the age of 65.
- Ethnicity: African American males are at higher risk for developing and dying from prostate cancer. Asian and Hispanic males are at a decreased risk.
- Family history: A positive family history increases the risk of developing prostate cancer.
- Genetics: There are some gene mutations that increase the risk of prostate cancer, including the BRCA1 and BRCA2 mutations. These are the same genes that increase the risk of breast and ovarian cancers in women.
- Diet: Diets high in red meat and lower in fruits and vegetables may increase cancer risk.
- Location: Prostate cancer is found more frequently in North America, the Caribbean, Australia, and parts of Western Europe, as compared to the rest of the world.
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