PSA test

The PSA (Prostate-specific antigen) test is a blood test. Used with other tests it can help doctors diagnose prostate cancer.

PSA is a protein made in the prostate gland. Some PSA leaks into the blood and can be measured in a test. A small amount of PSA in the blood is normal.

If the prostate becomes enlarged, inflamed, or infected, larger amounts of PSA get into the blood. The amount of PSA in the blood may also increase if there is cancer in the prostate.

A raised PSA level may be a sign of prostate cancer. But it can also be caused by other things, such as non-cancerous prostate conditions.

Screening is a way to try to find cancer early in people who do not have any symptoms. In the UK, there are screening programmes for breast, bowel, and cervical cancer.

There is no UK national screening programme for prostate cancer. The PSA test on its own is not accurate enough to be used in a screening programme to diagnose early prostate cancer. It may falsely diagnose prostate cancer and may also miss some cancers.

Some studies show that lives may be saved by PSA screening because it may lead to prostate cancer being diagnosed at an early stage. But they also show that screening may lead to:

• more invasive tests, such as a prostate biopsy, which can cause complications
• more treatment of slow growing prostate cancers that would never have caused serious harm.

Treatment side effects include:

• urinary incontinence
• bowel problems
• or difficulty getting an erection.

For a screening programme to be effective, the benefits need to outweigh the disadvantages.

If you decide to have the PSA test, your GP or nurse will take a blood sample. They send it to a laboratory to be tested. You can ask how long the result will take.

If you are having the PSA test, you usually have a rectal examination as well. The doctor gently inserts a gloved finger, using lubricating gel, into your back passage (rectum) to feel the prostate. It may be uncomfortable, but it is quick and should not be painful.

Different things other than prostate cancer can raise PSA levels. This includes common prostate conditions, such as:

• benign prostatic hyperplasia (or hypertrophy) called BPH for short
• prostatitis (inflammation of the prostate).

BPH and prostatitis can both cause a raised level of PSA in the blood, but they are not prostate cancer.

There are some situations where PSA levels can be raised for a short while. These may affect how accurate the test result is. If you decide to have the PSA test, your doctor may suggest you wait for a while if any of the following apply to you.

Things that can raise a PSA level are:

• urine infections
• recent ejaculation (within the last 48 hours)
• having a tube in your bladder to drain pee (urinary catheter)
• recent prostate biopsies
• prostate or bladder surgery
• exercising energetically 48 hours before the test (some doctors include cycling in this advice)
• receiving anal sex or prostate stimulation during sex (it is best to avoid this for 1 week before the PSA test).

Some medicines that help with urinary symptoms caused by BPH can lower the PSA level in your blood. They include:

• finasteride (Proscar^®)
• dutasteride (Avodart^®, Combodart^®).

If you have the PSA test, always tell your GP or nurse about any medicines you are taking. This includes ones you buy over the counter, complementary therapies or drugs made from herb and plant extracts.

It can help to think about the possible benefits and disadvantages before having a PSA test. You can talk these over with your GP or nurse as well as checking if you have any risk factors for prostate cancer.

• You may feel reassured if the PSA result is normal.
• If your PSA level is raised, you can continue to have it monitored.
• It can help, along with other tests, diagnose prostate cancer early when treatments may cure it or help you to live longer.

• If your PSA level is raised, you may feel anxious.
• It is possible to have a normal PSA level and still have prostate cancer.
• If your PSA level is raised you may not have prostate cancer but will need further tests, which may include a biopsy.
• If you are diagnosed with prostate cancer, you need to make decisions about treatments.
• Treating early prostate cancer may not help you to live for longer and the side effects of treatment can affect your quality of life.

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

• use plain English
• explain medical words
• use short sentences
• use illustrations to explain text
• structure the information clearly
• make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.