PSA tests

What is a PSA test?

PSA (Prostate Specific Antigen) is an enzyme made by the prostate gland that is found in the blood. PSA is a blood test that measures the activity of the prostate. It helps detect the early signs of prostate cancer.

  • If you are aged 40-49, your PSA level should not be more than 2.5mcg/L.
  • If you are aged 50-59, your PSA level should not be more than 3.5mcg/L.
  • If you are aged 60-69, your PSA level should not be more than 4.5mcg/L.

Should I have a PSA test?

A PSA test is not perfect. It can be raised because of other reasons. Your PSA blood test can be raised because of:

  • enlarged prostate or benign prostatic hyperplasia
  • prostatitis (swelling or inflammation of the prostate)
  • urine infection (can be infection of the bladder, kidneys or tubes)
  • prostate cancer

Other reasons for raised PSA include:

  • recent ejaculation (within the last 48 hours)
  • vigorous exercise or cycling (within the last 48 hours)
  • receiving anal sex or prostate being stimulated during sex (it is advised to avoid a week before the PSA test)

PSA blood test alone cannot tell if you have prostate cancer. It is the first step in deciding if you need more tests. It is important to think about the pros and cons of having the PSA blood test done.

Pros:

  • PSA blood test or screen can help pick up prostate cancer early.
  • PSA blood test is simple and widely available.
  • Prostate cancer is easy to treat and more likely easy to be cured when diagnosed early.
  • The number of deaths from prostate cancer has significantly gone down since PSA test has become widely available.
  • Some men would like a PSA test to be done for reassurance.

Cons:

  • PSA blood levels can be raised for other reasons. It does not mean prostate cancer is present.
  • Some prostate cancers are slow growing and will more likely not spread outside the prostate.
  • Some fast growing prostate cancers are not picked up on a PSA test.
  • Not all men diagnosed of prostate cancer needed treatment.
  • Some men would get anxious or will worry knowing that they have been diagnosed of prostate cancer.

If you would like to have your PSA test done, you can talk to your GP or book a virtual appointment with us.

What if my PSA test result is raised?

If your PSA test is high, it does not mean that you definitely have prostate cancer.

Our team will call you and refer you to the local hospital within 2 weeks to speak to a specialist.

When you are spoken to by the specialist, the hospital team will usually arrange for a scan of your prostate. It is called an MRI scan.

The MRI scan does not diagnose prostate cancer. It looks at any abnormal areas in your prostate. It helps your doctor see if there is anything suspicious in the prostate, if you may need a biopsy, where to take biopsies of the prostate, and if it has spread outside of the prostate.

Before the MRI scan, you will be asked if you have any metalwork in your body. This includes:

  • pacemaker or implantable defibrillator (to treat abnormal heart rhythm)
  • surgical clips, pins or plates
  • any metal fragments in the body (includes dental fillings)

The doctor will inform you of the results of the scan.

If there are no abnormal areas seen in the prostate, the doctor may inform you that you do not need any more tests.

If the scan shows abnormal areas in the prostate, the doctor may invite you to have a biopsy of the prostate. Biopsy is taking some samples of the prostate and look at it under the microscope.

Before the biopsy, you will be asked if you are taking anticoagulants or blood thinners. You may be asked to stop your blood thinners a few days before the biopsy.

Biopsy confirms if:

  • it is cancer or not
  • how risky it is

For more information about prostate biopsy, please visit Transperineal biopsies.pdf (baus.org.uk).