A Primer on PSA

When people look back even five years, they would never say that they are now exactly where they expected to be. Unexpected circumstances, such as changes in employment, natural disasters, or serious diagnoses force us to alter our life paths. Being diagnosed with prostate cancer is one of these game-changers, a sizzling acid that dissolves any feeling of invincibility that we retained from youth. If you have never had to fight prostate cancer, you might not be familiar with common terms that men learn as they start their lifelong battle. One of these terms is PSA.

PSA stands for prostate-specific antigen, a protein produced by cells in the prostate gland. The prostate produces PSA as an essential ingredient in semen. PSA liquefies semen, allows sperm to swim in it, and possibly contributes to the breakdown of cervical mucus in vaginal intercourse. It’s specifically important to our conversation because a man’s risk of prostate cancer is directly correlated to the levels of PSA in his blood.

If you opt to go in for a PSA screening, this is what you should expect: the doctor will first take a blood sample, as PSA is present in the blood. If your PSA levels are higher than expected, you might be asked to get another screening to compare with the first. If your PSA is confirmed high, your doctor may recommend more regular tests with additional digital rectal examinations (DRE), which check for abnormal lumps on the prostate. Suspicious lumps may warrant a biopsy, by which doctors check the prostate flesh directly for cancerous growths.

Before you do this, you should be aware of the issues. For the past 50 years, PSA screenings have been recommended as a top-notch detection strategy for prostate cancer. In recent years, the benefits are not so clear. A high incidence of false-positive test results (where PSA levels are increased but no cancer is actually present) has led to over treatment and over diagnosis. And the complications that can occur in treatment for prostate cancer range from mere nuisance to devastation. PSA tests have been known to detect not only prostate cancer but also benign prostatic hyperplasia and prostatitis, neither of which is cancer. In light of this, don’t assume that your PSA reading is the only factor that decides your future. Ask your doctor other tests, in addition to PSA, that may be more sensitive to prostate cancer. PCA3 , a urine test, one of them, for example.

Five years ago, you probably had no idea where you would be today. Looking ahead, it’s important to be prepared for anything. We at XY Wellness aim to prepare you with an understanding of the problems you currently face or those you may encounter in the future. Understanding the role of PSA in cancer detection, the problem of over diagnosis, and the alternatives to PSA-tests is a fundamental aspect of mindful male health. And it’s the kind of knowledge that will save you a panicked Google search down the road. 

For more information on PSA, check out this "classic" post: PSA: Appropriate Use vs. Misuse and Abuse.