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The Prostate Specific Antigen (PSA) test is a blood test that is commonly carried out to screen for the presence of benign prostatic hyperplasia (BHP) and of prostate cancer. In spite of the fact that the test cannot in itself be used for diagnosis it is an excellent indicator and, together with other screening tests, PSA testing can point to the need for further investigation. PSA testing is normally recommended for men in high risk groups (such as those with a family history of the condition) once they reach the age of around 40 to 45 and for all men over 50 years of age. A single test in isolation will give a snapshot of prostate specific antigen levels in the blood and may show a problem immediately if you record an especially high PSA level. However, in the majority of cases, and where a prostate problem may be in its early development, an isolated test result will prove to be inconclusive and a further test will generally be suggested in a few weeks time. In fact, ideally testing ought to be carried out regularly two or three times each year so PSA levels can be viewed over time. As long as you record a normal PSA score then all is fine, but when your PSA scores start to increase they need to be watched closely. The speed with which PSA scores rise is normally called the 'PSA velocity' and as long as the increase is gradual and the velocity slow then it is once again often enough merely to monitor the situation as numerous things can influence PSA levels and seemingly increasing levels will often fall back to normal over time. However, if PSA levels start rising rapidly and the velocity is fast then further investigation is certainly needed. This pattern of PSA testing and monitoring has been performed for a long time but, despite the fact that the test has always been thought of as a good indicator of the need for further investigation, it was not until quite recently that we have been able to link specific PSA velocity to prostate cancer in a fashion that can indicate how aggressive prostate cancer is. In a recent study data pertaining to 950 men with prostate cancer who had undergone either radiation treatment or surgery between 1988 and 2004 at four hospitals was carefully scutinized. In every case each patient had been diagnosed as suffering from aggressive prostate cancer on the basis of an isolated very high PSA reading, the presence of an advanced stage tumor, a noticeable rise in PSA velocity during the year before diagnosis, the results of a biopsy indicating signs of an aggressive cancer at cellular level or a combination of two or more of these markers. This study also looked in detail at the post-treatment outcomes for all 950 men and discovered that a rapidly increasing PSA level that rose by 2 points or more in a twelve month period was the clearest indicator or the presence of an aggressive cancer. Until now we have been able to associate increasing PSA scores with the possible presence of prostate cancer but have had to guess to some extent about whether such a cancer might be aggressive and require correspondingly aggressive intervention. However, now we can say with a fair degree of certainty that if a PSA level rises by 2 or more points in a year then prostate cancer is almost certainly aggressive and requires swift and vigorous treatment.
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ProstateProblemCenter.com provides information on PSA results and on PSA normal score
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