Description of the test

The prostate gland produces seminal fluid, the liquid part of semen. It also produces a protein called prostate specific antigen (PSA). The PSA test is used to determine your level of PSA. Most men have some PSA in their blood. Finding a high level of PSA may mean that the prostate gland is enlarged, infected, inflamed, or cancerous.

Testing normally occurs in a clinic, at a doctor's office, or in a hospital.

How often should the test be performed?

Men at a low risk for prostate cancer but who are over age 50 should discuss having a test with their doctor. Men at a high risk should begin regular testing at an earlier age to allow early detection and possibly prevent problems with the prostate gland.

Why is this test performed?

The results of this test tell your doctor about your PSA level. Checking this level over a period of time will highlight changes. Any changes may indicate a problem with the prostate gland.

Your doctor will determine the most appropriate treatment while considering your PSA level, age, race, and medical history.

Are there any risks and precautions?

Although the PSA test is considered safe, it does have some risk of side effects or complications. Though rare, the side effects or complications may include:

• infection (if the area is not properly sterilized before the sample is taken)
• excess bleeding from the puncture
• bruising where the needle was inserted

People with bleeding disorders or anyone taking medication that reduces the ability of the blood to clot (e.g., warfarin, ASA, or other anticoagulants) should tell the technician before the blood samples are taken. These conditions and medications may require special attention at the time of testing.

What happens during the test?

Blood is collected into one or more small vials labelled with your information.

The technician should wear fresh latex gloves and use a new, single-use needle for each procedure.

A technician or nurse wraps a wide elastic band around your upper arm to help locate the vein. Once the vein is located, usually on the inside of your elbow, the area is disinfected using alcohol swabs. The technician inserts a needle into a vein and pushes a vial onto the needle to collect the blood. The elastic band is removed and after the blood is collected, the needle removed and discarded. You will have to hold a small piece of cotton over the area until bleeding stops. A small bandage will be applied to hold the cotton in place.

The test is almost painless for most people, although you may feel a slight pinch when the needle is inserted. The vials of blood are then sent to a laboratory for analysis.

How should I prepare for this test?

Before having a PSA test, you need to avoid sex and sexual activity for two to three days. Waiting until certain infections go away is also important (e.g., urinary tract or prostate infections). Some doctors will recommend that you wait for a week after having an examination of the prostate before having your PSA level measured.

If you have had a cytoscopy recently, it is recommended that you wait a few weeks before doing a PSA test to get the best results.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any medication allergies and medical conditions that you may have.

Ask your doctor or pharmacist whether you need to stop taking any of your medications before the test.

What can I expect after the test?

Normal values for the PSA test depend on what the laboratory and doctor consider normal. Some doctors use age-specific ranges to compare results while others use the same range for all men regardless of age. The units of measurement are nanograms per millilitre (ng/mL).

A high PSA level may be a sign of prostate cancer. However, your PSA level may also be high due to other conditions of the prostate gland including inflammation of the prostate (prostatitis) or enlargement of the prostate (a non-cancerous condition). Other tests such as a biopsy (taking a tissue sample from the prostate with a needle) are needed to confirm whether you really do have prostate cancer.

If the PSA level has been tested several years in a row, an increase might be considered important, even if the level is not very high, particularly for men at high risk.

Men who have had treatment for prostate cancer sometimes have their PSA level checked regularly. An increase could be an early sign that the cancer is coming back.

Normal values for the PSA test depend on what the laboratory and doctor consider normal. Some doctors use age-specific ranges to compare results while others use the same range for all men regardless of age. The units of measurement are nanograms per millilitre (ng/mL).

A high PSA level may be a sign of prostate cancer. However, your PSA level may also be high due to other conditions of the prostate gland including inflammation of the prostate (prostatitis) or enlargement of the prostate (a non-cancerous condition). Other tests such as a biopsy (taking a tissue sample from the prostate with a needle) are needed to confirm whether you really do have prostate cancer.

If the PSA level has been tested several years in a row, an increase might be considered important, even if the level is not very high, particularly for men at high risk.

Men who have had treatment for prostate cancer sometimes have their PSA level checked regularly. An increase could be an early sign that the cancer is coming back.

Some people experience slight bruising or tenderness at the site where the needle enters the vein. Keeping pressure on the area after the needle is removed helps prevent bruising.

Results

Normal values for the PSA test depend on what the laboratory and doctor consider normal. Some doctors use age-specific ranges to compare results while others use the same range for all men regardless of age. The units of measurement are nanograms per millilitre (ng/mL).

A high PSA level may be a sign of prostate cancer. However, your PSA level may also be high due to other conditions of the prostate gland including inflammation of the prostate (prostatitis) or enlargement of the prostate (a non-cancerous condition). Other tests such as a biopsy (taking a tissue sample from the prostate with a needle) are needed to confirm whether you really do have prostate cancer.

If the PSA level has been tested several years in a row, an increase might be considered important, even if the level is not very high, particularly for men at high risk.

Men who have had treatment for prostate cancer sometimes have their PSA level checked regularly. An increase could be an early sign that the cancer is coming back.