Are you afraid of the PSA test? Let's talk about it simply (PSA Test)

Are you over 50? Or are you in your late 40s? Then your doctor may have told you to get a PSA test. Some people get a little scared and nervous when they hear this name. "Isn't this a test to check for prostate cancer?" they think. What exactly is PSA? What does this test look for? Should you be worried about it? Today we will talk about all this very simply, in a way that you can understand.

Simply put, what is this PSA test?

PSA is short for Prostate-Specific Antigen . This is a type of protein in our bodies. It is made by the prostate gland, which is only found in men. Imagine, this gland is about the size of a small walnut, located below our bladder.

So, just like healthy cells in the prostate, cancer cells also make a protein called PSA. But the important thing is, cancer cells usually make a lot more of the PSA protein . The PSA test is a very simple blood test. It measures the amount of PSA protein in your blood. If the PSA level in your blood is higher than normal, it indicates that there may be something wrong with your prostate, possibly a risk of cancer.

The doctor will usually perform a digital rectal exam (DRE) along with the PSA test. This checks the size, shape, and texture of the prostate gland for any abnormalities, such as lumps.

Does the 'normal' PSA level change with age?

Yes, absolutely. This is something that many people don't really know. There is no one "normal" value for everyone. As we age, even if we don't have any disease, our prostate gland gets a little bigger. So PSA levels naturally rise a little bit.

PSA is usually measured in nanograms per milliliter (ng/ml) . As a general guideline, here are some normal values ​​for age:

Keep in mind that these are just general guidelines. Just because your PSA is slightly higher than this limit doesn't necessarily mean you have cancer. We'll talk about that in a bit.

When should you have a PSA test?

This is also an important issue.

• Those at average risk: Unless you have a strong family history of prostate cancer, doctors recommend getting a PSA test every two to three years, usually after the age of 50 .
• Those at high risk: If you are at high risk, your doctor may recommend starting this test at age 40-45 .

Who are these people at higher risk?

• Family history: If your father, brother, or son has had prostate cancer, or if several members of your family have had the disease.
• Genetic factors: Research has found that men of African descent have a higher risk of developing prostate cancer and a younger age at which it develops.

Additionally, the PSA test is used to monitor the success of treatment for prostate cancer and to determine if the disease has recurred.

Things to know before the test

Okay, so let's say you're scheduled to have a PSA test. To get an accurate report , there are a few things you need to consider before the test. These things can affect your PSA value.

Tell your doctor about these things:

• If you are taking medication for Benign Prostatic Hyperplasia (BPH) (e.g. Finasteride, Dutasteride).
• If you are using medication like `Finasteride (Propecia®)` for hair loss.
• If you have recently undergone prostate surgery (TUR).
• If you have had a prostate biopsy within the last 6 weeks.
• If you have recently had a catheter inserted.
• If you have a liver disease (such as `Cirrhosis`, `Hepatitis C`).
• If you currently have a urinary tract infection (UTI) or have had one within the last 3 months.

Do not do these things 48 hours before the test:

• Do not engage in any sexual activity (including masturbation). Ejaculation can temporarily increase PSA levels.
• Avoid strenuous exercise, especially things like cycling, which can temporarily increase PSA levels.

Only by following these instructions exactly will we be able to measure your actual PSA level.

Does a high PSA level necessarily mean cancer?

No. Absolutely not. This is the most important thing for everyone to remember. Don't panic if your PSA report says it's high. It just means that something is going on in your prostate gland and needs to be investigated further.

Besides cancer, here are some other reasons why PSA levels can be elevated:

• Benign Prostatic Hyperplasia (BPH): This is not cancer. It is a common condition that affects many men as they age.
• Prostatitis: PSA can increase due to infection and swelling of the prostate gland.
• Urinary Tract Infection (UTI): A urinary tract infection can also cause an increase in PSA levels.
• Recent medical procedures: Because of things like the biopsies and catheterizations we talked about earlier.
• Vigorous exercise and sexual activity: These can temporarily increase PSA if done close to the test.

If the PSA value is high, what happens next?

If your PSA level is high for your age, your doctor will not panic, but will plan your next steps accordingly.

In general, if the PSA value is between 4 and 10 (ng/ml) , the probability of having prostate cancer is about 25%. If the value is greater than 10 , the probability can be more than 50%.

Therefore, the doctor may recommend tests like these:

• Another PSA test: Maybe do another test in a few months to see if the value is still high.
• MRI scan: An MRI (Magnetic Resonance Imaging) scan can be done to take detailed images of the prostate and check for any suspicious areas.
• Prostate Biopsy: The only way to know for sure whether you have prostate cancer is with a biopsy. This involves taking a small sample of tissue from the prostate and examining it under a microscope to see if there are any cancer cells.

What are the symptoms of prostate cancer?

This is also very important. In the early stages of prostate cancer, there are usually no symptoms . That's why tests like PSA are important. As the disease progresses, symptoms such as:

• Urinary difficulties: Frequent urination, weak urine stream, burning or pain when urinating (Dysuria), difficulty controlling urine.
• Bleeding with urine or semen.
• Frequent back, hip, or chest pain: (This means the cancer may have spread to the bones).
• Weight loss without any reason.
• Erectile dysfunction or pain during ejaculation.

If you have these symptoms, it doesn't necessarily mean you have cancer. However, if you have these symptoms, it's important to see your doctor as soon as possible for advice.

Are there things we can do to control PSA levels?

There is no magic formula that can lower PSA levels overnight. However, some research shows that maintaining a healthy lifestyle and diet can help maintain prostate health and control PSA levels.

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