Sunday, October 17, 2010

Why should we care about PSA?


Many people are not clear about exact PSA guidelines and its importance in prostate cancer screening. The PSA stands for Prostate Specific Antigen and has a lot of health implications. PSA level is measured in blood and its normal reference range is below 4 nanograms. Whether PSA should be included in the routine screening is still debatable and the main reason behind this ambiguity is the lack of PSA screening to increase life span. Till now there is no consensus on a particular guideline which needs to be followed. You can read more about different guidelines put forward by various organizations from click here.

Again, the question is why should we care about PSA level if it is not helpful! Actually, it is not completely true; PSA has many other benefits that your physician want to consider based on your health status. There are many possible causes for increase in PSA level, some of them are prostate enlargement, prostate infection, prostate cancer, prostate biopsy, recent ejaculation, digital rectal exam, bicycle riding and aging. Yes, aging is one of the factors and PSA level increases as you age. Though there are many factors that can increase your PSA level, some of them causes temporary increase only but your physicians are particularly interested in repetitive persistent increase in PSA level because it is more reliable than a single spikes. A single spikes of PSA could be due to many minor issues and usually get back to normal as soon as you recover whereas repetitive increase suggest major concern in terms of prostate cancer and prognosis monitoring after prostate cancer treatment.

Thus, you can see that increase in PSA is not that alarming as compared to repetitive persistent increase. It is generally perceived that there is no added benefits of PSA screening after the age of 75 because prostate cancer is a slow growing tumour and it is not certain that PSA screening actually saves lives. However, major implication of PSA test is for people with family history of prostate cancer and for those undergoing prostate cancer treatment. Technically, PSA level play a vital role in monitoring cancer treatment efficacy and its relapse.

Although PSA screening is not mandatory at this time, but is it strongly recommended for someone at age 45-75 having increased risk for prostate cancer. However, its benefits in a sub population cannot be ignored.

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