The prostate has become very topical of late with several high profile individuals suffering from prostatic enlargement or prostate cancer.
The demand for a test for this has risen, and it is important that men over the age of 50 understand the pro's and con's of testing PSA.
PSA (prostate specific antigen) is a protein released from the prostate that can be detected in the blood. It can be raised for a number of reasons, not just cancer (see below RE 'false positives'). The normal range for PSA is also age dependent as generally speaking the prostate enlarges as men get older. When this goes on to cause symptoms it is called 'benign prostatic hypertrophy', simply meaning non-cancerous prostate enlargement.
The PSA blood level is also increased in other conditions. So having an increased PSA test result does not mean that you have prostate cancer. Experts disagree on how useful the PSA test is. There is a lot of ongoing research about PSA.
At the moment there is no national screening programme for prostate cancer in the UK.
Having a PSA test is a personal decision – what might be important to one person may not be to another and having the test might not be the right thing for you.
A "false positive" PSA test - where the PSA is high, but there is no evidence of prostate cancer can be as high as 75 out of 100 men, and this may lead to unnecessary investigations and side effects from the investigation. And even true positive results may lead to unnecessary treatment as many prostate cancers are slow growing and may not become evident during your lifetime.
Further information can be obtained from this information sheet or from NHS Inform around testing for prostate cancer.
If you decide that you wish to have a PSA test, please be aware that the following can increase the PSA and should be avoided before having a blood test.
- A urine infection
- Sexual intercourse
- Heavy exercise, particularly cycling
A fuller assessment of the prostate including a physical examination by a doctor is recommended should you have any of the following symptoms
- Poor urinary flow
- Urinary frequency (going very frequently to pass urine)
- Passing blood in the urine or semen
- Getting up multiple times at night to go to the toilet