Prostate Cancer Detection - Dr. David B. Samadi

Information on Prostate Cancer

Prostate Cancer Detection

deteccion del cancer de prostata

Prostate cancer screening consists of two examinations:

  1. A blood test that measures levels of Prostate Specific Antigen or PSA test. Annual PSA test screening should start at age 50 for the general population, but the right age to start the PSA test depends on the individual's level of risk.*
  2. A physical exam of the prostate, the Digital Rectal Exam or DRE. A quick and painless physical exam, where the doctor feels for bumps or abnormalities on the surface of the prostate which might indicate tumor growth. The word “digital” refers to the use of a finger, not a computer. If a bump or abnormality is found, a biopsy is needed to determine whether prostate cancer exists.*

General PSA Guidelines

  • Normal – 0,0-4.0 nanograms/milliliter – considered safe
  • Intermediate – 4.1-9.9 nanograms/milliliter – considered safe but can suggest the possibility of prostate cancer so speak with your doctor
  • High – 10.0 + nanograms/milliliter – dangerous and you should speak with your doctor immediately

Understanding High PSA Levels

Digital Rectal Exams (DRE) should always accompany a PSA Blood Test as they detect issues of the prostate, such as cancer, when used together. Although accurate, an elevated PSA alone does not automatically mean prostate cancer is present.

Higher PSA levels may be caused due to:

  • Older Age.
  • Injury to the prostate.
  • Prostatitis.
  • Extended pressure on the area from the penis to the rectum.
  • Sex within 24 hours of taking the PSA sample.
  • Urinary Tract Infection.
  • Testosterone Supplements.

Understanding Low PSA Levels

Generally, a low PSA is a good thing and means you have no further action to take. But, even men diagnosed with prostate cancer can have lower levels of PSA due to dilution.

Lower PSA levels may be caused due to:

  • Being overweight or obese (body fat decreased amount of PSA).
  • Anti-inflammatory drugs.
  • Cholesterol decreasing drugs.

If either test shows abnormal results, further testing such as a biopsy will be needed to identify whether prostate cancer exists. If both screening formats provide positive “normal” results, you should continue to get tested for prostate cancer every year as part of a comprehensive physical examination.

*The PSA test and DRE should be done concurrently to increase the accuracy of prostate cancer diagnosis and enable early prostate cancer treatment.

Prostate Cancer Screening and PSA Test Considerations

  • Annual screening with a PSA test should start at age 50 for the general population.
  • Men with one risk factor should get their first PSA test at age 45.
  • Men with more than one risk factor should start annual the PSA test at age 40.
  • Some men choose to take a single PSA test earlier, at age 35 or 40, to establish a “baseline” PSA level for future comparison.
  • A primary care physician can do both the PSA test and physical examination.
  • Those who cannot afford a doctor visit, should call a local hospital or clinic to learn about free screening.
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