PSA Count

A PSA count (Prostate Specific Antigen) is often part of a yearly prostate examination for men.

A digital prostate exam combined with a PSA test can give the doctor an indication of the health of the prostate gland and act as an early indicator for the presence of cancer.

Many doctors recommend a yearly PSA test for men over the age of fifty.

This test is also given to monitor the progression of disease in men with diagnosed prostate cancer.

PSA is derived from a blood test.

This test measures the amount of a specific protein enzyme manufactured by the prostate gland. The amount of this enzyme is usually low, but it may become elevated due to prostate problems like cancer, BPH (Benign Prostate Hypertrophy), infection, and inflammation.

A normal PSA range is 0-4 ng/ml. A count over 20ng/ml is considered to be highly elevated.

PSA as a Diagnostic Tool

While a high PSA count is not a definitive diagnostic tool for cancer due to the many variables that may affect the test results, it is useful for predicting the probability of developing prostate cancer.

A normal PSA result of less than 4 ng/ml carries a 25% incidence of prostate cancer while 80% of men with elevated PSA counts over 4 ng/ml develop prostate cancer.

Abnormal PSA test results are not necessarily caused by prostate cancer but there is a correlation between how quickly scores escalate over time and the development of cancer. Yearly PSA counts are useful in this regard to help the patient and doctor track overall prostate functioning and health.

PSA Doubling Time

When your PSA doubles within three years or less, a biopsy may be indicated. A low PSA doubling time may indicate an aggressive prostate disease.

Both cancerous and BPH may result in elevated PSA test results. The PSA ratio may help your doctor determine a probable cause of your high PSA test.

PSA (Free to Bound Ratio)

PSA is present in the blood bound to either a protein or floating freely. Benign prostate hypertrophy usually produces more free PSA while prostate cancer causes more bound PSA.

Therefore when your bound PSA is high and free PSA is low, there is an increased risk of cancer and a biopsy may be indicated.

On the other hand, when bound levels are low and free levels are high, it may be an indication of BPH. In this case the doctor may choose to take a watchful waiting approach to treatment.

Prostate Cancer Risk

The amount of free PSA to bound PSA is reflected in the PSA ratio and directly relates to the risk of developing cancer. When free PSA is 10% or less, the risk of developing prostate cancer is 50%.

Your PSA result in combination with a DRE (Digital Rectal Examination) has greatly improved the odds of catching prostate cancer in its early stages. The PSA test also helps your doctor differentiate between cancerous and benign prostate disease so the best course of treatment and further testing may begin.

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