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The Prostate-Specific Antigen Test (PSA TEST)

The prostate-specific antigen test (PSA test) has become one of the standard screening tools for prostate cancer. A high PSA level or a rising PSA density are usually the first indications of prostate cancer. Prostate specific antigen is an enzyme that the body uses to turn semen that has congealed after ejaculation back into the liquid. Some of the prostate-specific antigen will naturally enter the blood stream. A doctor who is using the PSA test to screen for prostate cancer will use the prostate-specific antigen as a tumor marker. A tumor, or the body in response to a tumor, will produce a tumor marker. In the case of the prostate gland, a swollen prostate will produce a higher PSA level simply because it is bigger. A high PSA score does not necessarily indicate prostate cancer, but problems such as Benign Prostatic Hyperplasia (BPH) or prostatitis.

To understand the prostate-specific antigen test, patients must familiarize themselves with nanograms, milliliters, PSA density, and PSA velocity. A nanogram is one thousand-millionth of a gram. PSA density refers to the nanograms of prostate-specific antigen per milliliter. PSA density is written: ng/mL. The PSA velocity measures how quickly the PSA density rises. An increase of density between yearly tests, for example from 0.4 ng/mL to 4.0 ng/mL, measures the velocity of a rising PSA level.

The prostate-specific antigen test has been a useful tool in determining whether or not someone has prostate cancer. The acceptable limit for men of all ages is 4.0 ng/mL.

Some doctors criticize the PSA test’s ability to accurately screen for prostate cancer at all. Prostate-specific antigen levels increase due to the enlargement of the prostate gland that accompanies age. Some doctors believe that the PSA test indicates only that the prostate gland has enlarged, not that a malignant tumor has caused the enlargement. While they do not believe that the PSA test should be discontinued, some researchers feel that a high PSA score should not be immediate grounds for a prostate biopsy.

We have already mentioned that factors besides prostate cancer may also raise the PSA score. Besides BPH and prostatitis, orgasm also has been shown to raise the prostate-specific antigen level as much as ten percent. Men receiving the PSA screening, therefore, may want to avoid sexual intercourse or masturbation before the test. Any activity that stimulates the prostate gland, including bicycling or motorcycle riding, can increase a PSA level. Orgasm and ejaculation or prostate-stimulating activities do not contribute to prostate cancer or prostate disease.



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