How do You Test for Prostate Cancer?

Regular health exams and tests are an important aspect of our lives as they can help detect problems before they start. They can also help in identifying problems early when you stand a better chance for treatment and cure. You should remember that by opting for earlier health checkups, you will be living a longer and healthier life. Now, who wouldn’t like that?

One of the important screenings that can have a significant impact on quality of life for men over the age of 50 is Prostate Cancer Checkup. And, do you know why? Prostate cancer checkup – often the dreaded disease would be in a fairly advanced condition before you even notice any symptoms at all. You will have to talk to your family physician or a urologist to know more about the problem. The question of prostate cancer checkup is a personal and quite a complicated one, and your doctor can decide whether prostate cancer screening is right and necessary for you.

The aim of having a prostate cancer checkup is to diagnose a disease or cancer at an early stage before even the symptoms manifest. It is then easier to treat, and there are more chances to cure cancer. Detecting certain types of prostate cancer early can be critical as elevated PSA results may reveal prostate cancer that may spread to other parts of your body, or they may reveal rapidly-growing cancer that may cause other problems.

Prostate Cancer Check Up – Tests For Detecting Prostate Cancer

Prostate Specific Antigen (PSA) Blood Test

The Prostate Specific Antigen (PSA) blood test helps to look for warning signs of prostate cancer. But these early prostate checks cannot determine if a man has cancer. If the result of one of these tests is abnormal, he may need a prostate biopsy to confirm the cancer.

Prostate Specific Antigen (PSA) is a substance made by cells in the prostate gland – both normal cells and cancerous cells. While PSA is mostly found in semen, a small amount is also found in the blood. The average PSA level for most healthy men is under 4 nanograms per milliliter (ng/mL) of blood, and as the PSA level goes up, you have a greater chance of having prostate cancer. Sometimes, you will find that men have prostate cancer, even though the PSA level is below 4. If your PSA level is high, your doctor may advise you to wait for some time and repeat the test, or else to undertake a prostate biopsy to find out if you have cancer.

Free PSA level

PSA exists as free PSA and a ratio of free to total PSA levels has clinical significance as quoted in a research done be Mayo laboratories. When total PSA is in the range of 4.0-10.0 ng/mL, a free:total PSA ratio < or =0.10 indicates 49% to 65% risk of prostate cancer depending on age; a free:total PSA ratio >0.25 indicates a 9% to 16% risk of prostate cancer, depending on age.

Normal PSA levels

The amount of PSA in your blood is measured in nanograms of PSA per millilitre of blood (ng/ml). PSA levels can range from 1ng/ml to hundreds of ng/ml. The following is the normal level and raised levels of PSA.

• For ages 50-59, the PSA level is considered raised if it is 3ng/ml or higher.
• For ages 60-69, the PSA level is considered raised if it is 4ng/ml or higher.
• For ages 70 or over, the PSA level is considered raised it is 5ng/ml or higher.

There are some factors that may affect the PSA levels.

PSA Level may also Increase Due to a Number of Other Factors, such as:

• An Enlarged Prostate:

Conditions such as Benign Prostatic Hyperplasia (BPH), a non-cancerous enlargement of the prostate, can raise PSA levels.

• Old Age:PSA levels normally go up slowly as men get older, even if they have no prostate abnormality.
• Prostatitis:This is an infection or inflammation of the prostate gland that can raise PSA levels.
• Ejaculation:This can temporarily make the PSA go up for a short time. Therefore, doctors suggest that men abstain from sex and ejaculation for 2 days before testing.
• Urologic Procedures:Certain urological procedures that affect the prostate, such as a prostate biopsy or cystoscopy, can result in higher PSA levels for a short time. Sometimes, a digital rectal exam (DRE) might also raise PSA levels slightly.
• Medicines: Some men who take male hormones like testosterone or other medicines that raise testosterone levels may see a rise in PSA.
• Urinary Infection:If you have an active urinary infection, the test will not give the correct result.

The Prostate-specific antigen (PSA) blood test has certain pros and cons that need to be considered before you go in for a PSA test.

Pros

• If the test result is normal, you will be happy.
• You will get an indication of cancer before the symptoms develop.
• You will get an indication of cancer at an early stage and treatment can be started earlier that can prevent cancer from spreading to other organs.
• PSA testing may reduce your risk of dying from prostate cancer.
• In the case of advanced cancer, earlier treatment is beneficial and will extend life.

Cons

• Sometimes, it may not detect the cancer and provide false hopes.
• It cannot differentiate between slow-growing and fast-growing cancer.

Digital Rectal Exam (DRE)

A Digital Rectal Exam or DRE is a prostate check that involves the doctor inserting a gloved, lubricated finger into the rectum to feel for any bumps or hard areas of the prostate that might show evidence of cancer. This exam can be a bit uncomfortable – more so for men who have hemorrhoids. And, it is definitely not painful and only takes a short time. But, the DRE is less effective than the PSA blood test in detecting prostate cancer. Many early cancers may not be detected by a DRE. Therefore, a DRE is not recommended as a substitute for the PSA test.

Men often wonder and ask the question, “How often should I undergo a prostate cancer checkup procedure?” It is suggested that men over the age of 50 should undergo a prostate health check once a year.

PSA velocity test

This is a rate of increase of PSA level year over year in an elderly male. A PSA rate of change (PSA velocity) greater than 0.75 ng/mL/year were at increased risk of being diagnosed with prostate cancer.

Imaging studies which can benefit early diagnosis of prostate cancer

Ultrasound scan – trans abdominal and trans rectal ultrasound scans can together help in initial non invasive investigation of suspected prostate cancer.
MRI prostate scan – is suitable for confirming prostate cancer lesions and for proper staging of disease.