What happens next? Your GP should discuss all of this with you, to help you decide what to do next. Regular PSA tests After some men have had their first PSA test they might want to have regular tests every few years, particularly if they have an increased risk of prostate cancer. Advantages It can help pick up prostate cancer before you have any symptoms. It can help pick up a fast-growing cancer at an early stage, when treatment could stop it spreading and causing problems. A regular PSA test could be helpful, particularly if you have an increased risk of prostate cancer.
This could detect any unusual increase in your PSA level that might be a sign of prostate cancer. The PSA test can miss prostate cancer. For example, one major study showed that 1 in 7 men 15 per cent with a normal PSA level may have prostate cancer, and 1 in 50 men two per cent with a normal PSA level may have a fast-growing cancer.
If your PSA level is raised you may need a biopsy. This can cause side effects, such as pain, infection and bleeding. But in most hospitals, men now have an MRI scan first, and only have a biopsy if the scan finds anything unusual.
Being diagnosed with a slow-growing prostate cancer that is unlikely to cause any problems or shorten your life may still make you worry, and may lead you to have treatment that you don't need.
But most men with low-risk, localised prostate cancer now have their cancer carefully monitored instead, and only have treatment if the cancer starts to grow. Should I have a PSA test? Am I at increased risk of prostate cancer? If my PSA level was normal, would this reassure me? What would happen if my PSA level was higher than expected? Would my local hospital do an MRI scan before deciding whether to do a biopsy? If I was diagnosed with slow-growing prostate cancer that might never cause any problems, would I still want to have treatment, even though it could cause side effects?
Or would I be comfortable having my cancer monitored instead? Worried about going to the GP? He told me the decision was mine and suggested I think it over, talk to my partner, and come back if I wanted one. If they still say no, try speaking to another GP or practice nurse.
If they also say no, speak to the practice manager at your GP surgery. Your GP surgery should have information about its complaints procedure. You can follow this procedure, or write to the GP or practice manager explaining your complaint. The NHS website has more information. In Scotland : you can complain to your local health board. The Patient Advice and Support Service can provide information, advice and support.
Get more information from NHS Inform. In Wales : you can complain to your local health board. Your local Community Health Council can help with this. Health in Wales has more information. The Patient and Client Council can provide advice and support.
Get more information from nidirect. What is a baseline PSA test? There is currently no screening programme for prostate cancer in the UK.
List of references. Urol Clin North Am. The Lancet. January Obesity and Prostate Cancer: Weighing the Evidence. Eur Urol. Clin Cancer Res. Prostatitis and its Management. Eur Urol Suppl. Published Accessed January 4, Board of Community Health Councils. NHS Complaints procedure - how we can help. Accessed July 29, Cancer Research UK. Cancer incidence for common cancers Accessed December 12, Prostate cancer incidence statistics: by age Prostate cancer incidence statistics: Lifetime risk of prostate cancer Accessed July 6, Cao Y, Ma J.
Cancer Prev Res Phila Pa. Acute Bacterial Prostatitis: Diagnosis and Management. Am Fam Physician. Associations of lower urinary tract symptoms with prostate-specific antigen levels, and screen-detected localized and advanced prostate cancer: a case-control study nested within the UK population-based ProtecT Prostate testing for cancer and Treatment study.
BJU Int. Genetic markers a landscape in prostate cancer. Mutat Res Mutat Res. Preoperative PSA velocity and the risk of death from prostate cancer after radical prostatectomy. N Engl J Med.
Pretreatment PSA velocity and risk of death from prostate cancer following external beam radiation therapy. Body mass index and incidence of localized and advanced prostate cancer--a dose-response meta-analysis of prospective studies. Ann Oncol. September In general:. If your levels are still high, your doctor might recommend one of the newer prostate cancer screening tests available today.
These tests can help better assess your risk for prostate cancer and determine whether a biopsy is necessary. Only a prostate biopsy can definitively diagnose prostate cancer. Prostate Cancer Screening Ages 40 to 54 The PSA test is a blood test that measures how much of a particular protein called prostate-specific antigen is in your blood.
While the general guidelines recommend starting at age 55, you may need PSA screening between the ages of 40 and 54 if you: Have at least one first-degree relative such as your father or brother who has had prostate cancer Have at least two extended family members who have had prostate cancer Are African-American, an ethnicity that has a higher risk of developing more aggressive cancers Prostate Cancer Screening Ages 55 to 69 This is the age range where men will benefit the most from screening.
The median PSA for this age range is 0. For men in their 60s: A PSA score greater than 4. The normal range is between 1. Therefore, determining what a high PSA score means can be complicated. There is a lot of conflicting advice about PSA testing. To decide whether to have a PSA test, discuss the issue with your doctor, considering your risk factors and weighing your personal preferences.
Prostate cancer is common, and it is a frequent cause of cancer death. Early detection may be an important tool in getting appropriate and timely treatment.
Prostate cancer can cause elevated levels of PSA. However, many noncancerous conditions also can increase the PSA level. The PSA test can detect high levels of PSA in the blood but doesn't provide precise diagnostic information about the condition of the prostate.
The PSA test is only one tool used to screen for early signs of prostate cancer. Another common screening test, usually done in addition to a PSA test, is a digital rectal exam.
In this test, your doctor inserts a lubricated, gloved finger into your rectum to reach the prostate. By feeling or pressing on the prostate, the doctor may be able to judge whether it has abnormal lumps or hard areas. Neither the PSA test nor the digital rectal exam provides enough information for your doctor to diagnose prostate cancer.
Abnormal results in these tests may lead your doctor to recommend a prostate biopsy. During a prostate biopsy, samples of prostate tissue are removed for laboratory examination. A diagnosis of cancer is based on the biopsy results. For those who have already been diagnosed with prostate cancer, the PSA test may be used to:. Medical organizations vary in their recommendations about who should — and who shouldn't — get a PSA screening test. Discussing with your doctor the benefits, limitations and potential risks of the PSA test can help you make an informed decision.
A PSA test may help detect prostate cancer at an early stage. Cancer is easier to treat and is more likely to be cured if it's diagnosed in its early stages.
But to judge the benefit of the test, it's important to know if early detection and early treatment will improve treatment outcomes and decrease the number of deaths from prostate cancer. A key issue is the typical course of prostate cancer. Prostate cancer usually progresses slowly over many years. Therefore, it's possible to have prostate cancer that never causes symptoms or becomes a medical problem during your lifetime.
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