Treatment Options

Prostate-Specific Antigen (PSA) Screening for Prostate Cancer

Intermediate Value

A prostate-specific antigen (PSA) test involves taking a sample of blood to measure the amount of PSA in the bloodstream. A digital rectal exam is usually done along with PSA testing. The prostate gland lies just in front of your rectum so a digital rectal exam, where a doctor inserts a gloved finger into the rectum allows the doctor to feel any bumps or hard areas in your prostate. PSA is a protein produced by normal prostate cells and then released in small amounts into a man's bloodstream by the prostate gland. It is normal for men to have low amounts of PSA. PSA testing does not diagnose cancer but it can be used with other tests to determine if prostate cancer is present.

PSA levels generally increase with age. As men age, the prostate may become a source of troubling and inconvenient problems that do not necessarily include cancer. It is important that men know early on what changes may occur and how those changes could eventually affect their health. PSA levels can increase as a result of an injury, a digital rectal exam, sexual activity, inflammation of the prostate gland (prostatitis), or prostate cancer.

Prostate cancer is the second most common form of cancer. It is the second leading cause of cancer-related death in men. PSA screenings are controversial because it is not yet known if the test actually saves lives. In addition, research is still needed to determine if the benefits of the test outweigh the risks of follow-up diagnostic tests and cancer treatments. Research is being done to determine if PSA screening reduces the number of deaths due to prostate cancer. PSA and digital rectal exams are being studied to determine if yearly screenings to detect prostate cancer decrease a man's chance of dying from the disease. It will take several years before the results of these studies are available. It is important to know and discuss the advantages and disadvantages of PSA testing with your doctor. One abnormal test may not indicate a need for extensive testing since various factors can cause PSA levels to fluctuate. If PSA levels continue to increase over time, other tests may be needed.

Things to Consider

  • Prostate-specific antigen (PSA) is a protein produced by normal prostate cells.
  • PSA testing can detect cancer in its early stages.
  • The U.S. Food and Drug Administration (FDA) has approved a PSA test along with a digital rectal exam to help detect prostate cancer in men age 50 and over, and for monitoring individuals with a history of cancer for reoccurrence.
  • Recommendation for a PSA screening varies from doctor to doctor.
  • It is important to discuss the advantages and disadvantages of testing with your doctor.
  • Most doctors and medical organization agree until there is more evidence, men should learn all they can about the benefits and limitations of early screening.

Results

Intermediate Value

Will I live longer if I have this procedure?

Yes, if PSA testing leads to early prostate cancer detection and treatment, it may lengthen you life.

Will the PSA testing improve my quality of life?

Yes, if prostate cancer is detected early, then early treatment may improve the quality of your life.

Does the PSA testing make my symptoms better?

No, there are no symptoms in most early cases of prostate cancer.

Safety

Significant Value

How safe is this for me?

There is very little risk from having a blood sample taken from a vein. You may develop a bruise at the puncture site and in rare cases the vein may become inflamed. If you have a bleeding problem or are on blood thinning medication, you should tell you doctor before the blood sample is drawn.

Potential benefits:

  • Early detection can lead to early treatment
  • Tests can be used to monitor the response to treatment
  • Tests can be used to monitor reoccurrence of cancer after treatment

Potential concerns:

  • Testing is not 100 percent accurate
  • Uncertain or false test results may result in unnecessary follow-up tests and biopsies
  • Testing cannot distinguish between cancerous and non-cancerous conditions
  • Small cancers may be detected that would never become life threatening, putting a man at risk from unnecessary treatment such as radiation or surgery

Comparison

Intermediate Value

Alternative testing includes:

 

  • Digital rectal exams, which help a doctor detect prostate cancer; this is usually done along with PSA testing
  • Ultrasound of the prostate gland to see if the prostate is enlarged, inflamed, or has abnormal growths
  • Additional testing, often determined by the results from the PSA and digital rectal exam

Cost

Intermediate ValueThe average cost of a PSA test is estimated to range from $70 to $400 dollars.

The cost may or may not be covered by your health benefits plan.

Sources

The following are off-site links off-site link :

American Cancer Society. (2009, July). Detailed Guide: Prostate Cancer. Can prostate cancer be found early? Retrieved October 7, 2010 from http://getyourscreentest.com/docroot/CRI/content/CRI_2_4_3X_Can_prostate_cancer_be_found_early_36.asp.

Centers for Disease Control and Prevention. Prostate cancer screening: A decision guide for Africian Americans.  Retrieved October 7, 2010 from http://www.cdc.gov/cancer/prostate/pdf/aaprosguide.pdf.

Centers for Disease Control and Prevention. Prostate cancer screening: A decision guide. Retrieved October 7, 2010 from http://www.cdc.gov/cancer/prostate/pdf/prosguide.pdf.

National Cancer Institute. (2004, August). The prostate-specific antigen (PSA) test: Questions and answers. Retrieved October 7, 2010 from http://www.cancer.gov/PDF/FactSheet/fs5_29.pdf.

National Cancer Institute. (2009, September). Understanding Prostate Changes: A Health Guide for Men. Retrieved October 7, 2010 from http://www.cancer.gov/PDF/4dba13db-81fb-4d8d-9c2d-d0c00a048f57/prostate_booklet.pdf.

Next Review Date

11/11/2011

This document has been classified as public information.

Table of Findings

results:  intermediate value

safety:  significant value

comparison:  intermediate value

cost: intermediate value


total: intermediate value

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Page modified:May 18, 2012