- October 8, 2018
- Prostate
- David Omarov
In this article we will look at the normal level of the total prostate-specific antigen PSA.
This test is a laboratory blood test whose purpose is to determine the amount of prostate-specific antigen in men. PSA is a protein produced in the body by the prostate gland.
An increased PSA in the blood may indicate abnormal functions of the prostate gland and should be considered the first alarm bell for the patient.
When PSA increases, this does not necessarily indicate the appearance of a cancerous tumor in the gland; it can also signal some kind of inflammatory processes occurring in the prostate.
The PSA test and its results are considered a reason for the treating urologist to determine further actions in therapy and diagnostics. Donating blood for PSA is included in the standard list of procedures as part of prostate diagnostics.
Knowing the normal level of total prostate-specific antigen (PSA) is very important.
Total PSA
PSA is a glycoprotein secreted by prostate epithelial cells. Given that PSA is formed in the paraurethral glands, only very small amounts can be detected among women.
The half-life of PSA is typically three days. A significant increase in its level in the serum is sometimes found with hypertrophy of the male gland, and, in addition, with its inflammatory pathologies and urinary retention.
This test is used to measure common prostate specific antigen as a way to detect cancer in patients who are fifty years of age or older. To diagnose prostate cancer, a prostate biopsy is required. This test is prescribed for serial PSA measurements to monitor patients with malignant tumors.
Advantages
Monitoring the concentration of this protein provides early detection of relapses and metastases in comparison with other methods. In this case, changes even within normal boundaries are considered informative. After a total prostatectomy, PSA should not be detected.
Its detection may indicate residual tumor tissue, distant or regional metastases. It should be taken into account that the level of residual concentrations ranges from 0.04 to 0.1 nanograms per milliliter, and any excess of this level indicates a relapse.
What are the indications for this analysis?
This test for common prostate specific antigen is performed for certain purposes:
- The process of monitoring the progress of prostate cancer and the overall effectiveness of therapy.
- If you suspect the appearance of a prostate tumor after various studies (for example, after a rectal digital examination or ultrasound diagnostics).
- For patients who have received radical cancer treatment for prostate cancer, this test is recommended every four months.
- The analysis is done as part of a preventive examination of men over forty years of age. It is carried out in order to identify the dynamics of the amount of prostate-specific antigen.
How should you prepare for a PSA test?
In preparation for the study in question, the following recommendations must be adhered to:
- For eight hours before the test, no food is allowed; juices, coffee, tea and alcohol are excluded.
- It is also recommended to abstain from sexual intercourse for five to seven days before the test.
- It is advisable to take the test before an examination by a urologist or ten to fourteen days after it.
- Directly after a prostate massage or performing a rectal digital examination, cystoscopy or bladder catheterization procedure, and, in addition, a transrectal ultrasound examination and after any other mechanical actions on the male gland, it is advisable to wait at least two weeks before taking a PSA test, and after a biopsy prostate for at least one month.
Why can the total prostate specific antigen (PSA) deviate from the norm?
What causes an increase in the total dog?
A slight, insignificant increase in PSA in men may be associated with the occurrence of inflammation (prostatitis) or benign hyperplasia (adenoma) of the prostate.
Mechanical action on the prostate (in the form of massage, biopsy, cystoscopy, acute urinary retention or bladder catheterization) can also cause a temporary increase in PSA.
True, the most pronounced and at the same time stable increase is usually associated with prostate cancer.
Norm of total prostate-specific antigen PSA
The male body is designed in such a way that the prostate grows in size with age, and this is a completely natural process.
Along with the prostate, the PSA value, which is measured in nanograms per milliliter, usually increases.
Therefore, when doctors talk about the normal level of this protein, it is important to consider what age the patient is currently talking about. Below we present the norm of prostate specific antigen in the analysis according to age:
- In men under the age of forty, this hormone should be 1.4 nanograms per milliliter.
- From forty to forty-nine years, this figure is 2.5 nanograms per milliliter.
- Between the ages of fifty and fifty-nine, the level will be 3.5 nanograms per milliliter.
- From sixty to sixty-nine, this value equals 4.5 nanograms per milliliter.
- From seventy to seventy-nine, the rate of the protein in question in analyzes is usually 6.5 nanograms per milliliter.
An elevated PSA level, in combination with other examinations such as prostate resonance imaging and rectal examination, may be a reason for the treating urologist to refer the patient for a prostate biopsy.
Very rarely, there may be patients (we are talking about one percent of cases) in whom, due to a low PSA, there is a chance that he has prostate cancer.
As a rule, practice demonstrates that in such cases we are talking about the presence of aggressive forms of prostate cancer.
The total specific antigen PSA is a very informative indicator.
An increase in PSA: does this mean that the patient has prostate cancer?
An increase in PSA in itself does not indicate the appearance of prostate cancer. However, urological clinics in Germany keep statistics and have developed the following scheme, which draws a parallel between the PSA indicator and the chances of having prostate cancer. Statistics were collected based on a survey of two thousand two hundred men:
- If a patient's PSA value is less than 2 nanograms per milliliter, there is a 7.1 percent chance that they have prostate cancer.
- If a patient's PSA reading is between 2 and 3.9 nanograms per milliliter, there is an 18.7 percent chance that they have prostate cancer.
- If a patient's PSA reading is between 4 and 5.9 nanograms per milliliter, there is a 21.3 percent chance that they have prostate cancer.
- If a patient's PSA value is between 6 and 7.9 nanograms per milliliter, then there is a 28.6 percent chance that they have prostate cancer.
- If a patient's PSA value is between 8 and 9.9 nanograms per milliliter, then there is a 31.7 percent chance that they have prostate cancer.
- If a patient's PSA value is more than 10 nanograms per milliliter, then there is a 56.5 percent chance that he has prostate cancer.
According to statistics, thirteen percent of men over fifty-five years of age have a PSA blood value greater than 4 nanograms per milliliter, but this does not mean that they have male gland cancer.
As stated earlier, an increased PSA can be caused by both prostate cancer and adenoma of this organ (in this case we are talking about benign hyperplasia).
Among other things, enlargement is also provoked by prostatitis, infections in the genitourinary system and the like.
Reliable information about the properties of the disease, be it adenoma or prostate cancer, can only be obtained directly after a biopsy. Currently, a biopsy of the male gland is the only method that can determine the nature of the tumor with a 100% guarantee.
Total and free PSA
A blood test for such a specific prostate antigen is used as a tumor marker in the diagnosis of cancer.
There are two values for this protein in the blood: bound and free, and the sum of these two indicators is the total PSA.
The ratio of free PSA to total is expressed as a percentage, which looks approximately as follows: total is 5.55, bound - 0.97, and free - 18. The reference value is less than 15%.
The lower the percentage, the greater the chance that the deviation from the norm of the tumor marker (common prostate-specific antigen - total PSA) was caused by a tumor of a malignant nature.
If the figure is less than fifteen percent, then this should necessarily serve as a reason to refer patients for further examination, namely, ultrasound, magnetic resonance imaging and prostate biopsy.
How should you donate blood to determine the PSA level?
In medical practice, doctors often face disagreements with generally accepted standards that are used throughout the world. But nevertheless, there are certain standards for conducting a urological examination that are universal for everyone. So, the following standards must be adhered to:
- PSA can be taken no earlier than four weeks after a prostate biopsy.
- This test is also taken no earlier than four weeks after completing a course of antibiotic use.
- It is not necessary for patients to take a test to determine the PSA indicator on an empty stomach; however, it is advisable to avoid eating fatty foods before the analysis.
- Immediately two days before the analysis, avoid any physical activity, and, in addition, sexual activity.
- You should not expose your body to emotional stress two to three hours before the test.
How often should you get a PSA test?
German urologists recommend that men over forty years old undergo an annual urological examination, which will include a PSA test. In particular, such a study should be carried out for men whose close relatives (brother, father) have had cases of prostate cancer.
It is now clear that this is a prostate-specific antigen in the blood.
PSA test after prostatectomy
After performing a prostatectomy (as removal of the prostate gland is called), the value of the protein in question should tend to zero.
According to radiologists, a PSA value of more than 0.1 nanograms per milliliter after removal of the gland indicates a recurrence of prostate cancer.
The most modern medical diagnostic examination today is PET CT. This examination makes it possible to detect even small foci of cancer cell spread.
We looked at the normal level of total prostate-specific antigen PSA.
Source: https://cureprostate.ru/422510a-obschiy-psa-prostatspetsificheskiy-antigen-norma-u-mujchin
Total and free PSA values are normal
Recently, unfortunately, prostate diseases have become one of the most common problems with men's health. Diseases of this organ, common and rare, bring a lot of inconvenience and discomfort to men, and sometimes pose a threat to life.
One of the criteria for diagnosing various prostate pathologies is a general and free PSA test. The normal level of prostate specific antigen in the blood of a healthy man is from 0.2 to 4 ng/ml.
PSA: origin and function in the body
To understand the importance of PSA test values, you need to understand what this substance is and where it comes from in male blood.
Prostate specific antigen is a protein in nature and is produced by the epithelial cells of the prostate tubules. Synonyms for its name are tissue kallikrein-3, gamma seminoprotein, prostate antigen.
Functionally, it is an enzyme (serine protease) that dilutes sperm, irrigates the urethra (urethra) before ejaculation and dissolves cervical mucus (entering the vagina from the cervix in women), facilitating the easy passage of sperm into the uterine cavity.
In semen, the prostate antigen level is 1 mg/ml. And in the blood, as mentioned above, it is 4 ng/ml. To make the difference in the content of this substance clear, remember that 1 mg is 1,000,000 ng. The low blood level of gama-semiprotein is explained by the presence of a special barrier that does not allow it into the blood.
With the development of various pathological changes in the prostate, the vascular permeability of this organ increases, and the tissue-blood barrier reduces its effectiveness. Because of this, prostate proteins, including prostate antigen, enter the male blood serum.
Forms and norms of PSA
Doctors and laboratory technicians sometimes write incomprehensible words in their documentation. For example, as a result of a blood test: total PSA, free PSA - what is it?
Prostate antigen is present in two types:
- free PSA – not bound to any other proteins;
- bound PSA – bound to the carrier protein alpha1-antichymotrypsin.
Together, these two forms represent the total PSA. It is to determine this form that tests are taken when there is a suspicion of prostate disease.
If the level of total prostate antigen is elevated, an additional study is prescribed to determine the free fraction of this protein.
A prerequisite for obtaining accurate test results is that total and free PSA be determined from one blood sample.
- The ratio of total and free PSA in blood serum is as follows:
- Total PSA = free fraction + bound fraction.
- The proportion of free PSA is only 10%, the rest is associated with prostate antigen.
For men of different ages, there are corresponding standards for the content of tissue kallikrein-3. Along with the entire body, the epithelial cells of the prostate also age. Because of this, the level of gamma semiprotein in the blood increases.
| Man's age, years | Upper limit of normal PSA, ng/ml |
| Up to 49 | Up to 2.5 |
| 50-59 | Up to 3.5 |
| 60-69 | Up to 4.5 |
| More than 70 | Up to 6.5 |
To be precise, the age standards indicated above are reference book data. In practical medicine, urologists consider the following values to be the upper level of normal in male blood serum up to 50 years of age:
- Total PSA – norm 4 ng/ml;
- Free PSA – normal 0.04-0.5 ng/ml;
- Bound PSA is the norm 3.5-3.96 ng/ml.
Diet for prostate cancer: rules and recommendations
Indications for PSA analysis and reasons for its increase
Prostate problems can occur in men of any age. But most often this happens after 40 years. Therefore, upon reaching this age, each representative of the stronger sex should undergo a blood test for prostate antigen levels at least once a year for the purpose of preventive examination.
At a young age, men usually come to the urologist if any signs of the disease occur. Similar symptoms include:
- frequent night urination;
- feeling of incomplete emptying of the bladder;
- pain when urinating;
- partial excretion of urine.
The doctor performs a digital rectal examination of the prostate gland to determine its consistency. If lumps are present, a number of instrumental and laboratory tests are prescribed, including a blood test for prostate antigen.
An increase in the level of this protein can be due to various reasons. First of all, these are various types of pressure and effects on the prostate.
These may include: recent ejaculation, digital examination, transrectal ultrasound, cystoscopy or insertion of a catheter into the bladder, taking organ tissue for biopsy.
Pathological reasons for an increase in the content of this antigen include:
- benign prostatic hyperplasia (BPH);
- prostate carcinoma (cancer);
- inflammation of infectious origin;
- ischemia of the prostate vessels;
- prostate infarction.
- If an excess of the prostate antigen norm is detected, the doctor will necessarily show oncological alertness and conduct additional examination, which is necessary if prostate cancer is suspected.
- Increased levels of blood gamma-semiprotein:
- 4-10 ng/ml – suspicion of prostate carcinoma. This is the “gray area” of the concentration of a given protein. This level of prostate antigen indicates a high risk of developing any pathology of this organ, including oncology.
- 10-20 ng/ml – high risk of prostate carcinoma.
- Above 40 ng/ml – may indicate the presence of metastases.
If there is an elevated level of total prostate antigen, additional laboratory testing is prescribed. Now a new analysis is being evaluated: total and free PSA in one portion of blood. This is necessary to determine the nature of the process in the organ: benign or malignant.
The ratio of antigen fractions in different pathologies is not the same. During the cancer process, the level of bound PSA increases and the level of the free fraction decreases.
This is an important diagnostic sign: with prostate cancer, the level of free PSA is much lower than with a benign process and in a healthy state.
If the prostate antigen level is 4-10 ng/ml, a biopsy is not taken without the results of other studies. These values are considered ambiguous and require additional examination methods and repeated testing. A content of 10-20 ng/ml may be an indication for a biopsy.
Recently, cases of detection of prostate carcinoma with normal levels of kallikrein-3 have become frequent. This indicates the need for mandatory use of additional methods for diagnosing prostate cancer. These include: transrectal examination, ultrasound, MRI, CT, determination of the rate of change in the concentration of gamma-semiprotein in the blood, tissue biopsy.
Increased total PSA: what does it mean?
Once the diagnosis of prostate cancer is reliably made, all possible necessary treatment is carried out. The results of a prostatic antigen test are also used to evaluate the effectiveness of therapies. If the treatment gives the desired results, the level of kalleikrein-3 drops to 0.2 ng/ml. Keeping it at the same level or even increasing indicates the ineffectiveness of the therapy.
Assessment of the ratio of prostate antigen fractions in prostate carcinoma is carried out to determine the prognosis of the disease. The prognosis is considered favorable when the share of the free fraction is 15% out of 100%. If the free PSA level is below 15%, the prognosis is unfavorable.
Preparing for a PSA test
For this study to be accurate and truthful, you need to prepare for it. It should be done a few days after any impact on the prostate gland and after healing of possible inflammatory diseases.
Blood is taken:
- with mandatory abstinence from ejaculation for two days;
- three days after digital rectal examination;
- a week after transrectal ultrasound;
- two months after taking prostate tissue samples for biopsy;
- two weeks after bladder catheterization and cystoscopy;
- two years after transrectal removal of part of the prostate.
Even if you follow the rules for taking blood for PSA, there are factors that can distort the test result. Among them may be:
- blood hemolysis;
- chemotherapy drugs;
- high level of nitrates, ascorbic acid.
Medications such as finasteride, Proscar, Finast, and Avodart can reduce the results. Freezing the blood also affects the result of this study: it reduces the level of free PSA by 10-15%.
Pathological causes of increased PSA
Physiological reasons for prostate antigen levels above normal do not pose a danger and quickly disappear on their own. Various pathologies of the prostate, which are based on damage to its epithelial cells, require special attention.
Benign prostatic hyperplasia (BPH)
Previously, this pathology was called prostate adenoma. It causes an increase in the size of the gland, the formation of multiple nodules in its structure and the degeneration of epithelial cells. It is these cells that begin to secrete too much PSA. Characterized by a benign course and absence of metastases.
Prostate cancer (carcinoma)
A severe malignant disease characterized by an acute and rapid course and a high mortality rate. With it, the formation of atypical cells from the epithelium of the gland is observed. These cells produce excess amounts of PSA .
A feature of the course of prostate cancer is long-term asymptomaticity. This is due to the fact that the cancerous tumor grows outward and the man does not feel symptoms when urinating. Adenoma, unlike cancer, grows inward and compresses the urethra, giving corresponding symptoms.
Infectious prostatitis
The occurrence of this inflammatory disease can be caused by various bacteria:
- coli;
- Pseudomonas aeruginosa;
- Proteus;
- klebsiella;
- normal microflora of the genitourinary system (if it enters the prostate tissue it causes inflammation).
Conclusion
You should not immediately panic if your blood test reveals an elevated PSA level. Only 30% of the total number of men with elevated levels of prostate antigen were reliably diagnosed with prostate cancer. It is necessary to conduct many different studies and conduct a thorough differential diagnosis of various types of prostate pathology.
Source: https://oprostatite.info/urologiya/prostatit/zlokachestvennye/psa-svobodnyj-i-obshhij-norma-i-otklonenie
What does prostate-specific antigen indicate: normal and abnormalities
Prostate-specific antigen allows diagnosing various diseases in men in the prostate gland: its norm is set the same for all patients.
However, it has different limits for men belonging to different age categories.
So, what does an analysis for prostate-specific antigen mean and what its values may indicate, it will be useful for every representative of the stronger half of humanity to know.
What does PSA mean?
Prostate specific antigen (PSA) is a protein substance produced by prostate cells. This enzyme performs the function of splitting protein molecules into small elements. This causes dilution of the seminal fluid.
Most of the prostate specific antigen is contained in semen, a smaller amount is present in the blood. PSA is considered an oncological marker, the detection of which is required for the diagnosis and monitoring of prostate pathologies.
If the antigen level in the blood is exceeded, the doctor may suspect the presence of a cancerous tumor in the gland or a non-cancerous disease (prostatitis, prostate adenoma, etc.).
To study prostate specific antigen in quantitative terms, the doctor prescribes a blood test. Since PSA is an organ-specific marker, this protein is associated with only one male organ - the prostate gland. However, it is nonspecific in terms of only a single disease. Using the antigen, it is possible to diagnose various prostate diseases.
This is due to the fact that prostate specific antigen, with the development of any pathology in the gland, begins to be intensively produced by the cells of the ductal system. As a result, its level in the blood increases. Due to this feature, a blood test is prescribed when diagnosing various pathologies of this organ.
What is prostate-specific antigen?
Prostate specific antigen, entering the blood from the gland, can be detected in it in one of three states:
- free - not compatible with plasma protein substances;
- associated with macroglobulin, combined with the plasma transport protein substance;
- associated with chymotrypsin, combined with a high activity blood enzyme.
This division of PSA into types is very important, as it forms the basis of standard diagnostic tests. The following values are indicative for the doctor:
- Total PSA is an antigen that is free and bound to chymotrypsin;
- PSA free;
- ratio of free to total PSA.
Therefore, when prescribing a test to determine PSA levels, the doctor must clarify which type of antigen needs to be tested. Most often this is a common antigen. If its norm is increased, an extended examination is indicated, which involves identifying all three significant indicators.
What are the normal values?
The uniform norm of PSA in blood plasma is assumed to be less than 4 ng per ml. If the analysis shows data that fits within this framework, then you don’t have to worry about cancerous transformation of the prostate.
The doctor builds his conclusions in accordance with age-related fluctuations, in which the norm of the substance is determined by the age of the person being studied.
The norm (ng per ml) in this regard can take the following form for different age categories:
- 40-50 l - 2.5;
- 51-60 l - 3.5;
- 61-70 l - 4.5;
- 71 and more - 6.5.
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The doctor also takes into account the following values:
- less than the lower threshold of 2.5 ng per ml, since these values are equally important as those exceeding the upper limits of normal;
- the ratio of free to total PSA can vary from 12% to 100%;
- PSA density value is the ratio of the antigen level to the volume of the prostate according to ultrasound results, the norm is 0.15 ng per ml per cm³;
- the temporary increase in PSA is the norm of 0.75 ng per ml per year.
Why do deviations occur?
Factors of deviations exceeding the norm are as follows:
- increase in prostate size due to disease (prostate adenoma, BPH);
- age-related increase in prostate size;
- chronic form of prostatitis;
- malignant neoplasm in the prostate;
- ischemia or infarction of the prostate.
Reasons for deviations with a low PSA rate:
- low testosterone levels;
- prostate hypotrophy and its involution;
- the influence of drugs used in the treatment of the prostate.
To correctly interpret a PSA test, you need to consider the following:
- The level at which prostate specific antigen reaches a quantitative expression of about 10 ng per ml is called the gray zone. In this case, a prostate biopsy is recommended to exclude/confirm prostate cancer. The same procedure is prescribed when the value of PSA density is increased, its increase over the year, especially over a short period of time.
- An increase in PSA by more than 20 ng per ml signals prostate cancer with intraorgan localization of formation. A similar diagnosis is made if the norm of 12% ratio of free to total PSA is not achieved.
- An increase in PSA of more than 50 ng per ml is clear evidence of gland cancer with the presence of metastases in the internal organs and lymph nodes.
Is it possible to regulate PSA values?
It is entirely possible to lower actual PSA values. However, you can begin this step only after completely making sure that there is no malignant pathology in the prostate gland. Otherwise, this will cause diagnostic and medical errors, which can provoke the pathology to become inoperable.
In this regard, PSA should not be taken as a pathological indicator that must be reduced. Considering prostate specific antigen is considered more correct as a marker of a malignant process.
If there is a correlation between an increase in its quantity and age-related changes in the gland, inflammation or benign tissue enlargement, these conditions should be treated.
Then the characteristic signs will disappear and the PSA criterion will decrease.
How should I take the test correctly?
It is important to take into account the fact that the analysis involves taking blood from a vein.
It is impossible to achieve the most truthful research results if you do not adhere to certain rules for taking an antigen test. At the same time, proper preparation and adherence to certain nuances are important.
Blood is donated before lunch and on an empty stomach. During the day you do not need to eat anything fatty, spicy, fried, as well as a large amount of spices, or drink alcohol.
Donating blood in the morning is due to the fact that the body is not able to withstand a hunger strike for a long time, and not because it is guided by daily fluctuations in the concentration of PSA in the blood plasma.
During the day, blood concentration is little subject to change, so there is no fundamental difference when choosing a day for analysis.
When approaching the procedure for drawing blood from a vein, psycho-emotional stress and physical activity should be excluded. Do not smoke an hour or two before collecting biomaterial.
Blood donation is not prescribed for 10 days to two weeks after manipulations on the genital organs (urethral canal and prostate), such as massage, TRUS of the gland, cystourethroscopy.
An equally important condition for proper preparation is the exclusion of sexual intercourse and ejaculation for 2-3 days before the test date.
Please note: in addition to a biopsy, a procedure on the prostate gland such as transurethral resection can affect the increase in PSA concentration in the blood. In addition, reductase inhibitors taken (Penester, Prostan) increase the antigen level. It is imperative to take into account the effect of these medications over several months.
PSA is a very significant indicator in diagnosing pathologies in urological practice.
Its accurate assessment makes it possible to confirm a cancerous tumor in the gland at an early stage of its appearance. And determine the patient’s attitude to a specific risk group for prostate diseases.
Source: https://prostatis.ru/na-chto-ukazyvaet-prostatspecificheskij-antigen-norma-i-otkloneniya.html
Deciphering prostate-specific antigen in men: norm and deviations from the norm
Men's health largely depends on the condition of the prostate gland. The older a man gets, the more attention should be paid to this organ. To avoid serious problems in the future, there is a specific test for the normal level of prostate-specific antigen.
PSA: description and meaning of the marker
Characteristics of prostate-specific antigen
Prostate-specific antigen is produced by epithelial cells of the prostate to increase the liquid portion of sperm. This enzyme is capable of breaking down protein molecules into small components. The lion's share of the substance ends up in the sperm, and a small amount goes into the man's blood.
A blood test for prostate-specific antigen allows you to identify various disorders in the functioning of the organ, including such a serious problem as prostate cancer. Thus, prostate-specific antigen, or PSA, is a specific cancer marker for detecting a variety of prostate diseases, including cancer.
PSA comes in several forms, two of which are available for testing. It is a common and free antigen. For accurate diagnosis, it is important to take both of these indicators into account.
The amount of free PSA is about 10% of the total amount of this substance in the blood.
This indicator can demonstrate whether changes in the prostate are benign or malignant.
An analysis for prostate-specific antigen makes it possible to monitor the health of this important organ and promptly respond to possible changes in its functioning.
This test is recommended to be carried out annually upon reaching 40 years of age or as prescribed by a doctor. After 75 years, the analysis is not carried out, as it is no longer indicative.
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Proven methods for diagnosing disorders of the prostate gland, such as palpation and ultrasound, are not always able to accurately indicate the presence of possible diseases, while PSA highly reliably demonstrates the presence of various tumors, including malignant ones, as well as other problems of this organ .
It is very important that this test can demonstrate the presence of a malignant process at the earliest stages, when no external manifestations yet exist.
This guarantees high survival rate and a high percentage of cure even from this terrible disease. In addition to cancer, the analysis can indicate inflammatory diseases of the prostate gland, for example, prostatitis.
Quickly diagnosing the problem and starting treatment can preserve a man's erectile function and sexual health.
Appointment for analysis
PSA: indications for testing
A test for prostate-specific antigen is prescribed by a doctor according to indications and after the patient’s complaints, the main one of which is a change in urination. It becomes more frequent or less frequent, difficult and painful.
It is advisable for middle-aged and older men to undergo this analysis annually, even without problems with men’s health or the urinary system. It can help identify a range of potential diseases with a simple blood draw.
Early diagnosis can not only give a good result for maintaining normal potency, but also become an indicator of prostate cancer.
The doctor writes a PSA test to identify and evaluate the following diseases and conditions:
- For preventive purposes, to eliminate possible health problems of this organ.
- If you suspect inflammatory processes in the prostate.
- To diagnose adenoma.
- In order to detect prostate cancer in the early stages of the process.
- To determine the presence of inflammatory diseases of the genitourinary area.
- For the purpose of differentiating oncological and benign neoplasms in the prostate gland.
- To monitor the condition of the organ during surgery.
- To monitor the effectiveness of drug therapy for cancer.
- In order to exclude recurrence or return of a malignant tumor.
Carrying out this analysis can exclude possible diseases or give a picture of the existing process. Based on the PSA level, one can judge what type of disease may be present, assess its nature - benign or malignant, as well as the degree of development of the process.
Preparing for analysis
Proper preparation for a PSA blood test
A general practitioner, therapist, urologist, or surgeon can send you for the study. To carry out the test, venous blood is taken.
It is necessary to prepare in advance for the test in order to obtain the most accurate and reliable result.
For this purpose, you must follow the following doctor's recommendations:
- If the patient had a prostate massage, there should be a gap of at least 10 days between the procedure and the PSA test.
- Also, half an hour before the analysis, you need to calm down and not burden the body - mental and physical stress, as well as nervous tension can negatively affect the accuracy of the test.
- Smoking is allowed a maximum of half an hour before blood sampling.
- At least one day before the test, you must completely avoid eating heavy fatty foods.
- Ejaculation can also affect the accuracy of the test, so sexual intercourse or any other type of stimulation should also be avoided for at least 24 hours before visiting the clinic or laboratory.
Data in different medical institutions may vary slightly, so it is recommended to repeat tests in the same laboratory. In this case, possible errors will be minimal, and the diagnostic accuracy of PSA analysis will be as high as possible.
Explanation: normal
PSA norm in men by age
Prostate-specific antigen is a variable indicator and can change depending on the age of the man and the influence of various external and internal factors. Normal PSA values are considered to be between 0 and 4 ng/ml (nanograms per milliliter). However, experts from the USA and Western Europe consider the maximum normal value to be no higher than 3.5 ng/ml.
Depending on the age of the man, normal PSA values can range from 2.5 to 6.5 ng/ml.
Data from 4 to 10 ng/ml are called the “gray zone,” a condition that can be either normal or an indicator of prostate problems.
If PSA shows a level above 10 ng/ml, then this condition requires additional research, in particular, taking a biopsy (sample of gland tissue) to exclude or confirm the presence of cancer. Most often, a biopsy is performed using a special needle through the wall of the rectum. To ensure the accuracy of the procedure, it is controlled by ultrasound.
The most accurate results are obtained by combining three main methods of examining the prostate gland:
- Palpation of the prostate through the rectum
- Transrectal ultrasound
- PSA test
The following problems may cause an increase in PSA levels:
- Prostatitis
- Increased prostate mass
- BPH
- Prostate cancer
- Acute or chronic infectious process in the genitourinary tract
- Ischemia or infarction of this organ
- Prostate massage
- Ejaculation that occurred less than 24 hours before blood collection
Any activity that stimulates the prostate, such as cycling or horseback riding.
A low level of prostate-specific antigen in the blood may indicate the absence of various prostate diseases or that the treatment was effective and the disease was eliminated.
Deviations from the norm
Possible diseases
Any deviation from the norm of prostate-specific antigen in a man’s blood can be evidence of both the presence of an infection and an indicator of various types of neoplasms. It is believed that the higher the PSA value, the higher the risk that the tumor will be malignant.
With the help of this blood test, which is quite simple for the patient, fairly accurate conclusions can be drawn about the condition of the prostate gland.
Small deviations from normal values most often indicate prostatitis - an inflammatory disease of the prostate gland - or an adenoma - a benign degeneration of its tissues.
It is believed that the higher the PSA level, the greater the likelihood of having a terrible disease - prostate cancer.
Men over 50 years of age are at risk, so they must undergo this test without fail.
Regular examination is also necessary for those men who have a family history of prostate disease or cancer. Such people need to start getting tested as early as possible, without waiting for a critical age.
It is known that a PSA blood test is a specific marker of cancerous lesions of the prostate gland and can detect malignant cells long before the appearance of any signs of cancer. In this case, timely adoption of measures can save not only the health, but also the life of the patient.
In those men who avoided undergoing an annual examination and blood donation for PSA, cancer was often detected in terminal stages - the third and fourth.
Since deviations from the norm do not always mean 100% the presence of malignant tumors, only a comprehensive examination along with PSA analysis can give a complete picture of a specific disease.
Source: https://DiagnozLab.com/analysis/cancer/prostatspetsificheskij-antigen-norma.html
Psa norm: main characteristics of the analysis and indications for its delivery
If its value exceeds the established norms, then this is a consequence of pathological processes in the gland, so PSA testing helps diagnose diseases of the organ.
The PSA test is the most informative among other tests that detect prostate diseases. It can be used to determine inflammatory processes in the prostate and benign tissue growth, but the main purpose of PSA testing is to identify cancer cells.
When is a PSA blood test prescribed:
- with symptoms characteristic of a malignant tumor in the prostate;
- after the age of fifty, an annual analysis is performed to determine the PSA norm;
- annual examination after forty years if there are relatives with cancer;
- with an enlarged prostate gland;
- to identify the stage of a cancerous tumor;
- to monitor the progress of treatment.
Until recently, it was believed that the normal PSA value was up to 4.0 ng/ml, but medical practice has shown that cancer can develop at lower levels. Therefore, a PSA level exceeding 2.5 ng/ml can serve as a sign of malignancy, but only if there are other indirect factors.
- Total PSA
- Total prostate-specific antigen is equal to the sum of free and bound PSA.
- Identification of the total PSA index allows you to:
- diagnose the onset of pathology;
- examine the prostate for the purpose of prevention;
- identifying the PSA norm, assessing the results of prostate treatment;
- If a man has undergone surgery, a general PSA test helps identify relapses.
Free and bound PSA:
- free form - PSA is not bound to proteins;
- bound form - PSA is bound to alpha 1-antichymotrypsin.
There is only 10% free PSA in the male body. Free antigen testing can differentiate benign from malignant lesions.
The PSA test is a tumor marker that detects cancerous changes in the prostate, but high levels of the antigen may indicate the presence of other prostate diseases. If an elevated PSA is caused by prostatitis or adenoma, then they speak of a false positive test.
In order to avoid errors when making a diagnosis, the doctor uses the PSA coefficient, this allows one to evaluate the ratio of free and bound prostate-specific antigen. If bound PSA is elevated, then cancer is suspected, and if free, benign hyperplasia is suspected.
The PSA norm in men is considered to be no more than 4.0 ng/ml; if this indicator is exceeded, the patient may be referred for a biopsy, but elevated PSA is not always a sign of cancer. If a malignant tumor is suspected, the patient is prescribed additional tests.
Elevated PSA level in the blood, the norm is more than 4.0 ng/ml:
Exceeding the norm suggests that the prostate gland is under the influence of some processes, internal or external. It increases only when the barrier between prostate cells and the circulatory system is disrupted.
External effects on the prostate:
- examination of the gland by palpation;
- prostate massage;
- long bike rides;
- horse riding;
- violent sex on the eve of analysis;
- performing cystoscopy;
- placing a catheter in the bladder;
- aging of the body (age deviations);
- taking medications to treat benign tissue growths and certain medications.
If there are no such external effects on the prostate, then they talk about pathologies of the gland itself or other internal problems.
The PSA level in a man’s blood deviates in the following diseases:
- acute prostatitis;
- exacerbation of chronic prostatitis;
- inflammatory diseases of the urinary tract;
- prostate ischemia;
- prostate enlargement;
- benign hyperplasia;
- prostate infarction;
- malignant tumor.
Reduced PSA level in the blood, the norm is less than 2.0 ng/ml:
A low PSA index is normal, which means that the risk of developing pathological processes in the gland is minimal. A decrease in prostate-specific antigen indicates the effectiveness of treatment of prostate diseases.
Interpretation of the result
The PSA norm in men characterizes a healthy prostate gland. If PSA is elevated, then the doctor deciphers the indicators, and it is very important to take two tests at once - free and general. It is the ratio of indicators that makes it possible to diagnose cancer and differentiate it from other pathologies that are similar in symptoms to malignant formations.
The concentration of total PSA in the blood changes slightly; an increase in the index can indicate cancer, prostatitis, and adenoma.
In case of malignant formation, the level of free PSA is low, and in case of benign hyperplasia or inflammatory processes in the prostate, it is high.
A specialist, interpreting these indicators, can confidently diagnose cancer or exclude such a tumor.
note
The value of free PSA to total is determined in the range from 12 to 100 percent. The higher the score, the less likely the risk of developing cancer.
If the doctor determines cancer, then additional studies are carried out to prescribe adequate treatment.
Traditional treatment for prostate cancer is as follows:
- External beam radiation therapy is the most common method of fighting cancer. It involves irradiation of the diseased organ, the projection of the organ is determined by MRI.
- Brachytherapy is a type of radiotherapy that is performed in the absence of metastases. Considered the most effective technique today, the advantage of the operation is that the radiation source is supplied directly to the affected organ, eliminating the harmful effects on other tissues.
- Prostatectomy is a surgical procedure to treat prostate cancer. Such a radical measure is resorted to if other methods are not effective; as a result of the operation, the prostate gland, iliac lymph nodes and seminal vesicles are completely removed.
Before taking the analysis, you must follow a number of rules:
- During the day before the analysis, you should not eat fatty foods;
- on the day of blood donation, nervous and physical stress should be avoided;
- It is not advisable to smoke at least 30 minutes before blood sampling;
- You cannot take the test if less than 10 days have passed since the prostate massage;
- To avoid a false positive result, the test should not be done if there is inflammation of the urinary tract or after catheterization.
The older a man is, the more prostate-specific antigen is in the blood, so older people are recommended to donate blood annually to determine the PSA index. The data is entered into a table, and the doctor can clearly see how the indicators are changing and whether there are reasons for concern.
Blood test for dogs norm by age (ng/ml):
- up to forty - 1.4-2.5;
- up to fifty - 2.0-2.5;
- up to sixty - 3.1-3.5;
- up to seventy - 4.1-4.5;
- after seventy - 4.4-6.5.
A woman's PSA level is 0.2 ng/ml and is not used to detect cancer.
Source: http://prostatitoff.net/diagnostika/psa-norma/
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