Written By: Debjani Arora | Published : September 25, 2018 11:16 AM IST
An elevated PSA level doesn't really mean cancer. © Shutterstock
September is prostate cancer awareness month.
Like most cancers, prostate cancer is asymptomatic in nature, which means it shows no symptom until it is too late. The most common symptoms of this cancer like frequent urination, trouble urinating, straining during urination, a weak urine stream is usually brushed off as trivial issues. However, they are just symptoms that could be indicative of a prostate problem and not cancer per se. This is more a reason why people don t care too much and pay heed to these symptoms. But can never be sure whether you are safe or not and so screening for prostate cancer becomes necessary. It is recommended in India that men above the age of 50 go for a PSA blood test annually to keep a tab on prostate health.
PSA or prostate specific antigen is a protein secreted by the prostate cells and a simple blood test can tell us the levels of PSA in the blood. Elevated PSA level could make your doctor suspicious about your prostate health as it could act as a predictor of prostate cancer. So, should you worry if your PSA level is high? Well, there is a small amount of PSA circulating even in healthy men when the levels increase it could be indicative of the onset of cancer. But an elevated PSA level is not always due to cancer growth in the gland. An elevated PSA level could also be due to benign enlargement of the prostate, urinary infection or a prostate infection.
So, how can a PSA test help in screening for prostate cancer? Along with the PSA, your doctor will take into account other risk factors age, genetics, family history, other urinary problems to come to a conclusion. The risk of prostate cancer increases with age while family history and genetics also has a role to play. However, if your PSA is above 3 or 4 ng/ml your doctor may want to do a biopsy. This would involve taking one or more samples from your prostate gland to give them a clearer picture. Studies have shown that PSA levels that range between 2.9 to 4 ng/ml indicate that the cancer is confined to the organ and have lower progression rate [1].
Screening for prostate cancer can involve PSA test and rectal examination. But know that these tests can also turn out to be false positive or false negative. So, if your PSA level is high talk to your doctor. Sometimes urine tests are done to check for infections that could raise PSA level. Otherwise, a biopsy might be suggested. Occasionally having a biopsy can lead to infection of the prostate gland, which can be difficult to treat.
Prostate-specific antigen screening can diagnose prostate cancer early. However, recently experts have become concerned about these screening tests being done without consultation with an expert like an oncologist or a urologist. It is good to take preventive measures, but to ask every man after 50 to go for a prostate screening isn t necessary, says Dr Avinash Deo, Consultant Medical Oncologist, S L Raheja Hospital. Most of the time some cancers are low grade and slow growing which does no harm if left untouched. This is a reason it is believed that everyone may not benefit from screening. One must discuss the pros and cons of screening with one s doctor before undergoing the test. However, to be on the safer side an annual PSA check-up is recommended.
Reference:
Zhu H, Roehl KA, Antenor JA, Catalona WJ. Biopsy of men with a PSA level of 2.6 to 4.0 ng/mL associated with favorable pathologic features and PSA progression rate: a preliminary analysis. Urology. 2005 Sep;66(3):547-51. PubMed PMID:16140075.
