The PSA Test for Prostate Cancer | Health | Patient UK
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This leaflet is designed to help you decide whether to have the PSA blood test for prostate cancer. You might have no symptoms but just want to check that you don't have prostate cancer, or you might be thinking about the test because you have developed prostate symptoms. There are pros and cons about having the test which are detailed below.
What is the prostate gland?
Cross-section diagram of the prostate and nearby organs
The prostate gland (just called 'prostate' from now on) is only found in men. It lies just beneath the bladder (see diagram). It is normally about the size of a chestnut. The urethra (the tube which passes urine from the bladder) runs through the middle of the prostate. The prostate helps to make semen, but most semen is made by the seminal vesicle (another gland nearby).
The most common problem of the prostate is prostate enlargement (also called Benign Prostatic Hyperplasia). This is a benign (non-cancerous) condition where the prostate gets bigger ('enlarges') gradually after the age of about 50. By the age of 70, about 8 in 10 men have an enlarged prostate. This condition can cause symptoms such as passing urine frequently, difficulty in passing urine, etc. A separate leaflet gives more details about prostate enlargement.
The other main condition which can affect the prostate is prostate cancer.
Prostate cancer is a common cancer in older men. Every year in the UK about 22 000 men are diagnosed with prostate cancer. About 8 in 10 cases occur in men over the age of 65. It is rare in men under 50. Unlike many other cancers, prostate cancer is often present for years without you realizing it. This is because in many cases the cancer is slow growing and can take many years to cause any symptoms. By the age of 80, more than half of all men will have some cancer cells in their prostate - but only 1 in 30 of them will actually die from it.
However, some prostate cancers are fast growing and can spread to other parts of the body. It is these faster growing cancers that tend to cause the most problems and can be a cause of death.
A separate leaflet discusses prostate cancer in more detail.
What is the PSA test and who might have it done?
It is a blood test that measures the level of PSA in your blood. PSA stands for Prostate Specific Antigen. PSA is a protein made by the prostate which naturally leaks into the bloodstream.
Some men with symptoms of a prostate problem may consider having the test. The symptoms of benign prostate enlargement can be similar to the symptoms of a developing prostate cancer. Some men without any symptoms consider having the test to 'screen' for prostate cancer.
However, in both of these situations, the decision to have a PSA test is controversial as there are pros and cons. See below.
What does the PSA test tell me about my prostate?
A raised PSA level can be a sign that you have prostate cancer. The PSA level is often raised well before any symptoms of prostate cancer develop. So the test can help to detect early prostate cancers (which may have a better chance of being successfully treated than more advanced prostate cancers.) As a rule, the higher the PSA level, the more likely that you have prostate cancer.
However, a raised PSA level can also occur in other prostate conditions such as some cases of benign enlargement of the prostate and inflammation of the prostate (prostatitis). In particular, a PSA level that is mildly or moderately raised has a good chance of being due to a benign condition, but could be due to prostate cancer. Overall, about 2 in 3 men with a raised PSA level do not have prostate cancer.
Also, if you do have prostate cancer, a single PSA test cannot tell you whether a prostate cancer is slow or fast growing.
And also, in some cases, the PSA level may be normal even when there is cancer there. Up to 1 in 5 men with prostate cancer have a normal PSA level.
So, the PSA test is not an accurate test for prostate cancer."