How to Interpret a PSA (Prostate) Blood Test

A man's prostate gland assists with sperm activity and sexual pleasure. As men age, the prostate can become enlarged and cause various problems such as benign prostatic hypertrophy (BPH). In addition to men over age 40 (or younger depending on sexual activity and family history) getting an annual digital rectal exam in which the clinician can actually feel the size and shape of the prostate, the prostate-specific antigen (PSA) blood test should also be done. The PSA test can be somewhat confusing for patients to understand--so this article is going to help assist you with reading your PSA results along with your clinician.

Instructions

Difficulty: Challenging

Things You’ll Need:

• PSA blood testing prior to appointment
• DRE (digital rectal exam) at the time of the appointment or on a previous visit
• A written list of any symptoms/concerns you may want to discuss with your clinician

1. Get your PSA blood work done BEFORE your DRE. Some studies have indicated that the PSA can be falsely elevated post-DRE if the prostate is pressed and some "additional" antigen can be expressed in the blood resulting in a falsely high reading.
2. You should understand the causes of elevated PSA other than prostate cancer or an enlarged prostate. One of the most common causes of an elevated PSA in a man of any age is an infected prostate. You may feel sick, have a fever and feel a heaviness in you groin area. Also, have these symptoms checked out and treated as necessary.
3. Know when to get your PSA checked:
   
   Age 40 for high risk men that include those of African-American descent, men who have sex with other men and those with a family history of prostate cancer.
   
   Age 50 PSAs should become routine annual screening for all men.
4. The "normal" range for the PSA is 0 to 4 ng/mL. PSAs over 10 ng/mL are considered "high." PSAs between 4 and 10 ng/mL are considered "intermittent." The actual PSA number may not always reflect what is going for every patient, so it is essential that you also look at trends and not just an annual number.
5. Examining PSA trends means you know what your previous PSAs have been and if you are having any symptoms such as difficulty voiding, decreaded ejaculate, groin "heaviness" or pain. PSAs may slowly rise within the "normal" range but still may be need to be watched by you and your clinician. For example: if your last PSA was 1.5 ng/mL and it is now 3.0 ng/mL, then the value has gone up by 100 percent in a year's time. This may be an alert to you and your clinician to do additional and more frequent testing.

Tips & Warnings

• Avoid anal sex and/or a DRE at least 1 week prior to PSA testing.
• As with any health care advice on the Internet, this is for educational purposes only. You should see your nurse practitioner or physician for actual screening and testing of any medical condition.