Prostate specific antigen(PSA) is a tumor marker. It was isolated and purified by Ablin in 1970. But its use started only after one decade of its isolation. Now it is commonly used as tumor marker for prostate cancer screening. PSA is organ specific that means it is liberated from prostate but not disease specific. Raised PSA level does not always means that there is prostatic malignancy. Once PSA level is raised we have to see also other factors for rise in PSA level. So factors other than prostate cancer causing rise in PSA level are benign prostatic hyperplasia BPH, prostatitis, prostatic biopsy, trauma, instrumentation, urinary retention, catheterization, surgery of prostate, etc. Despite all the pros and cons of a PSA Test, it is best that one opts for the inexpensive test to be aware of the status of prostate cancer. It should also be noted that majority of the times there might be no alarming signs of prostrate cancer, making detection all the more difficult.
Start opting for PSA annual test, right after 50 yrs of age:
Men above 50 years coming to urology out patient department with urinary complaints should be screened for cancer prostate with serum PSA level. If patient has a family history of prostate cancer then PSA screening is recommended for men above 40 years. In USA men above 40 years are being recommended for PSA screening. If PSA level is more than 2.5 for men less than 60 years and more than 4.0 for men more than 60 years, prostatic biopsy is recommended to rule out prostate cancer.
In some types of prostatic malignancy PSA level may not rise. There is gray zone for PSA level between 4 to 10. So these men should be assessed by other means before subjecting for prostatic biopsy. In these cases free PSA, PSA density, PSA velocity are important for deciding before men being subjected for prostatic biopsy.
Meet the right Doctor:
There have been talks of subjecting yourself to a number of tests, without any use. It is important that you consult the right place, right doctor to ensure that no necessary tests are being recommended to you. You should question the reason for every test and also ask the doctor to explain the reports to you. Note that you should go through a PSA test or a biopsy only if the same is recommended by a specialized doctor – Urologist and if your initial PSA tests are abnormal.