PSA Total Most Popular

The PSA Total test contains 1 test with 1 biomarker.

Brief Description: The PSA Total test measures the levels of prostate-specific antigen (PSA) in the blood. PSA is a protein produced by the cells of the prostate gland. The PSA Total test is commonly used as a screening tool for prostate cancer and to monitor the progression of the disease. It provides valuable information about prostate health and helps detect potential abnormalities.

There are two types of PSA, complex and free, and this test will measure the total sum of both. This test does not specify how much of each. If a measure of each amount is desired the test PSA, Free and Total #31348 will be able to differentiate between each one.

Also Known As: Prostate Specific Antigen Test, PSA Test, Prostate test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is a PSA Total test ordered?

A PSA Total test may be ordered in several situations to assess prostate health:

  1. Prostate Cancer Screening: The test is commonly used as a screening tool for prostate cancer in men. It is often recommended for individuals over a certain age or those with risk factors such as a family history of prostate cancer.

  2. Monitoring Prostate Cancer: For individuals diagnosed with prostate cancer, the PSA Total test is ordered to monitor the progression of the disease, assess treatment effectiveness, and detect potential recurrence.

  3. Evaluation of Prostate Disorders: The test may be ordered to assess prostate health and investigate potential conditions such as benign prostatic hyperplasia (BPH), prostatitis (inflammation of the prostate), or other prostate-related disorders.

What does a PSA Total blood test check for?

PSA is a protein produced predominantly by cells in the prostate, a tiny gland that surrounds the urethra in males and generates a fluid that is a component of semen. The majority of PSA produced by the prostate is discharged into this fluid, but minor amounts can also be found in the bloodstream. This test determines how much PSA is present in the blood.

The PSA test is used to screen for and monitor prostate cancer as a tumor marker. It's a good tool, but it's not perfect, and most experts agree that asymptomatic men should only be screened after having a detailed discussion with their healthcare professionals about the benefits and dangers, and after making an informed decision to do so. PSA levels that are high are linked to prostate cancer, but they can also indicate prostatitis or benign prostatic hyperplasia. PSA levels rise with age in all men, but men of African American ancestry may have greater levels than other men, even at a younger age.

PSA is not a cancer indicator. The prostate biopsy, which involves taking small samples of prostate tissue and examining them under a microscope for abnormal cells, is the gold standard for detecting prostate cancer. The total PSA test and the digital rectal exam are used to evaluate whether a prostate biopsy is necessary.

The purpose of prostate cancer screening is to discover the disease when it is still contained within the prostate. Once the diagnosis of prostate cancer has been verified by biopsy, a treatment decision must be determined. As men get older, prostate cancer becomes more common, and many, if not all, of the tumors are slow-growing. While prostate cancer is the second leading cause of mortality in men, slow-growing prostate cancer is a rare cause of death. A pathologist may be able to tell the difference between cancers that grow slowly and spread to other regions of the body and cancers that grow quickly and spread to other parts of the body.

Overdiagnosis and overtreatment are two challenges that health professionals are currently dealing with. In certain situations, the treatment is worse than the cancer, with substantial side effects including as incontinence and erectile dysfunction possible. In general, neither the PSA test nor the DRE can indicate how a person's condition will progress.

In the blood, PSA is found in two forms: complexed and free. The total PSA test, which analyzes the sum of complexed and free PSA in the blood, is the most often used PSA test.

When the total PSA is only slightly raised, the free PSA test is occasionally used to help assess whether a biopsy should be performed. PSA is an enzyme, and when it is released into the bloodstream, some circulating proteins link to it and inactivate it. In BPH, benign prostate cells produce PSA that is not active, whereas malignant prostate cells produce PSA that is already protein-bound.

As a result, men with BPH tend to have greater levels of free PSA, while men with prostate cancer have lower levels. Even if total PSA is not dramatically raised, a relatively low amount of free PSA raises the chances of cancer.

Lab tests often ordered with a PSA Total test:

Alongside a PSA Total test, several other tests and evaluations may be ordered to further assess prostate health or investigate the cause of a PSA elevation. Here are some of them:

  1. Free PSA:

    • Purpose: PSA exists in two main forms in the blood: bound to other proteins or free (unbound). The free PSA test measures the amount of unbound PSA.
    • Why Is It Ordered: To help determine the risk of prostate cancer in men who have a borderline or slightly elevated total PSA level. A lower ratio of free PSA to total PSA can be associated with a higher risk of prostate cancer.
  2. Urine Analysis (Urinalysis):

    • Purpose: A test that checks the content of the urine.
    • Why Is It Ordered: To rule out urinary tract infections or other urinary tract disorders that can cause elevated PSA levels.
  3. Complete Blood Count (CBC) and Chemistry Panel:

    • Purpose: These tests assess overall health and the function of various organs.
    • Why Is It Ordered: Although not specific for prostate issues, these tests may be ordered to rule out or monitor other health conditions that could be causing symptoms or to prepare for a possible prostate biopsy or treatment.
  4. Testosterone Levels:

    • Purpose: Since testosterone can promote the growth of prostate cancer, levels are sometimes measured.
    • Why Is It Ordered: To provide information on hormone levels, which could be relevant for prostate cancer growth and may influence treatment decisions.

The decision to order these tests is usually based on the total PSA results, a patient's symptoms, age, family history, and overall risk of prostate cancer. They can be used to differentiate between benign prostate conditions (like benign prostatic hyperplasia) and prostate cancer, to determine the need for a biopsy, or to inform treatment strategies.

Conditions where a PSA Total test is recommended:

A PSA Total test is commonly ordered for:

  1. Prostate Cancer Screening: The test is used as a screening tool for prostate cancer, especially in individuals at higher risk or of a certain age.

  2. Monitoring Prostate Cancer: The PSA Total test helps monitor the progression of prostate cancer, assess treatment effectiveness, and detect potential recurrence.

  3. Evaluation of Prostate Disorders: The test aids in evaluating prostate health and investigating conditions such as benign prostatic hyperplasia (BPH), prostatitis, or other prostate-related disorders.

How does my healthcare provider use a PSA Total test?

Healthcare providers use the results of a PSA Total test to:

  1. Screen for Prostate Cancer: Elevated PSA Total levels may indicate the presence of prostate cancer or other prostate conditions, prompting further investigations or referrals for a prostate biopsy.

  2. Monitor Prostate Cancer: The test helps monitor PSA levels in individuals diagnosed with prostate cancer, assisting in treatment decisions, evaluating treatment response, and detecting potential recurrence.

  3. Assess Prostate Health: The PSA Total test aids in assessing overall prostate health and provides valuable information for the diagnosis and management of prostate-related conditions.

By effectively utilizing the results of a PSA Total test, healthcare providers can screen for prostate cancer, monitor prostate health, make informed decisions regarding patient care, and guide further diagnostic evaluations or treatments as necessary.

What do my PSA Total test results mean?

PSA test results can be interpreted in a variety of ways, and the cutoff values used by different laboratories may differ.

Total PSA levels below 4.0 ng/ml are considered unlikely to indicate the existence of prostate cancer. Some argue that this limit should be reduced to 2.5 ng/ml in order to detect more prostate cancer cases. Others contend that this might result in more malignancies being diagnosed and treated that aren't clinically important.

Men with a total PSA level of more than 10.0 ng/ml are thought to be at a higher risk of prostate cancer.

Total PSA readings of 4.0 to 10.0 ng/ml may suggest prostate cancer, benign prostatic hyperplasia, or prostate inflammation. These problems, as well as an increase in PSA levels, are more common among the elderly. The "gray zone" is defined as total PSA levels between 4.0 and 10.0 ng/ml. The free PSA may be beneficial in this range.

Prostate cancers produce primarily complexed PSA rather than free PSA. Prostate cancer cells create more free PSA, which does not bind to proteins. As a result, when men in the gray zone have lower levels of free PSA, they have higher levels of cPSA and a higher risk of prostate cancer. When individuals have high amounts of free PSA but low cPSA, however, the danger is reduced. The ratio of free to total PSA can assist the patient and his healthcare professional in determining whether or not a prostate biopsy is necessary.

Additional analyses of PSA test results are occasionally utilized to improve the total PSA's efficacy as a screening tool. They are as follows:

  • PSA velocity is the rate at which PSA concentrations fluctuate over time; if the PSA continues to climb rapidly over time, prostate cancer is more likely. If it rises quickly, the patient may be suffering from a more aggressive kind of cancer.
  • PSA doubling time is a kind of PSA velocity that quantifies the rate at which the PSA concentration doubles.
  • PSA density is a comparison of PSA concentration and prostate volume; if the PSA level is higher than one would predict given the size of the prostate, the likelihood of cancer is higher.
  • PSA ranges adapted to a man's age—Because PSA values typically rise with age, it has been advocated that normal ranges be customized to a man's age.

The PSA level should start to drop with prostate cancer treatment, and should be very low or undetectable at the end of treatment. If concentrations do not drop to extremely low levels, the treatment is ineffective. Following treatment, the PSA test is repeated at regular intervals to check for recurrence of cancer. Because even small increases can be important, persons who are impacted should have their monitoring PSA tests done by the same laboratory each time to reduce testing variation.

A test known as "ultrasensitive PSA" may be helpful in detecting cancer persistence or recurrence after therapy. PSA is detected at significantly lower levels in this test than in regular PSA tests. Increases in PSA related to the persistence or return of cancer, it has been proposed, can be detected much sooner using this test. The results of this test, however, should be regarded with caution. Because the test is so sensitive, even when no cancer is present, minor rises in PSA levels can occur from one time to the next.

Is there anything else I should know about the Prostate Specific Antigen Total test?

The blood sample is normally taken before the DRE since the DRE can induce a brief increase in PSA.

PSA levels will be dramatically elevated following prostate procedure such as biopsy or excision. Before surgery or six weeks after manipulation, a blood test should be performed.

A brief increase in PSA level can be caused by strenuous physical activity that affects the prostate, such as cycling. Ejaculation within 24 hours of a PSA test can result in higher PSA values, thus it's best to avoid it.

Some chemotherapy medicines, such as cyclophosphamide and methotrexate, can raise or lower PSA levels in high dosages.

PSA levels may briefly rise in some men as a result of other prostate problems, particularly infection. According to a research, nearly half of men with high PSA levels saw their levels return to normal after a period of time. Before taking any further action, several authorities urge that a high PSA be repeated between 6 weeks and 3 months following the initial high PSA. If there is indication that the prostate is infected, some doctors will prescribe antibiotics.

Most Common Questions About the PSA Total Test:

Basics of PSA Total Test

What is a Prostate-Specific Antigen (PSA) Total test?

The PSA test is a blood test that measures the amount of prostate-specific antigen in your blood. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below a man's bladder.

Why is the Prostate-Specific Antigen (PSA) Total test done?

The PSA test is done to screen for prostate cancer, to monitor treatment of the disease, or to check for cancer recurrence after treatment. It can also be used to diagnose and monitor other prostate conditions.

Understanding Test Results

What do the results of a Prostate-Specific Antigen (PSA) Total test mean?

A PSA level between 4 and 10 ng/mL is considered borderline and might be associated with a 25% chance of having prostate cancer. A PSA level over 10 ng/mL is often associated with a higher chance of having prostate cancer. However, many factors can cause PSA levels to fluctuate, so one abnormal result does not necessarily indicate a problem.

Is a high PSA level always indicative of prostate cancer?

No, a high PSA level does not necessarily mean prostate cancer. PSA levels can also be elevated due to benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate, prostatitis (inflammation of the prostate), or even recent ejaculation.

Can I have prostate cancer with a low PSA level?

Yes, while rare, it is possible to have prostate cancer with a low PSA level. Some types of prostate cancer do not produce much PSA and can remain undetected by the PSA test.

Specific Questions About the Test

Can medications affect a Prostate-Specific Antigen (PSA) Total test?

Yes, some medications, including those used to treat BPH or urinary conditions, can lower PSA levels. Inform your doctor about any medications you're taking before the test.

Can a Prostate-Specific Antigen (PSA) Total test be used to monitor the effectiveness of prostate cancer treatment?

Yes, PSA levels can be used to monitor the effectiveness of prostate cancer treatment. A decrease in PSA levels after treatment usually suggests the treatment is working.

Can other conditions affect the results of a Prostate-Specific Antigen (PSA) Total test?

Yes, conditions like prostatitis, urinary tract infections, or procedures like a prostate biopsy can increase PSA levels.

Can I eat before a Prostate-Specific Antigen (PSA) Total test?

There are no dietary restrictions before a PSA test, but it's always best to follow your healthcare provider's instructions.

How often should a Prostate-Specific Antigen (PSA) Total test be done?

The frequency of PSA testing depends on the individual's risk for prostate cancer, their current health, and their doctor's recommendation. Some may need annual testing while others may need less frequent testing.

Understanding the Specific Conditions

How is the Prostate-Specific Antigen (PSA) Total test used in cases of Prostatitis?

In cases of prostatitis, a PSA test can help assess the level of inflammation or infection in the prostate. PSA levels often rise when prostatitis is present.

How is the Prostate-Specific Antigen (PSA) Total test used in cases of Benign Prostatic Hyperplasia (BPH)?

In cases of BPH, PSA levels can be elevated. However, BPH is not a cancerous condition but can cause similar symptoms. Your doctor may use the PSA test in combination with other tests and exams to assess the severity of BPH and guide treatment decisions.

How is the Prostate-Specific Antigen (PSA) Total test used in cases of Prostate Cancer?

PSA is used as a screening test for the presence of prostate cancer. Higher levels of PSA can indicate the presence of cancer, but they can also be due to non-cancerous conditions like BPH or prostatitis. Therefore, elevated levels often warrant further testing to confirm the presence of cancer.

Can a Prostate-Specific Antigen (PSA) Total test be used to differentiate between BPH and prostate cancer?

No, the PSA test alone cannot differentiate between BPH and prostate cancer. Both conditions can cause an increase in PSA levels. Other diagnostic tools, like a digital rectal exam and prostate biopsy, are necessary for a definitive diagnosis.

How does Prostate-Specific Antigen (PSA) Total test relate to metastatic prostate cancer?

In men diagnosed with prostate cancer, a rising PSA level may indicate the cancer is not responding to treatment and may be spreading to other parts of the body (metastasizing).

Considerations and Risks

Is there a risk of overdiagnosis with the Prostate-Specific Antigen (PSA) Total test?

Yes, the PSA test can sometimes lead to overdiagnosis of prostate cancer, detecting cancers that may not be harmful or require treatment. This can lead to unnecessary treatments and associated side effects.

Is there an ideal age to start getting a Prostate-Specific Antigen (PSA) Total test?

The age at which a man should start getting a PSA test is a matter of some debate. Some guidelines suggest that men discuss the potential benefits and harms of PSA testing with their doctor in order to make an informed decision about whether to be tested. This discussion should start at age 50 for most men, or at age 45 for men at higher risk (such as African American men and men with a family history of prostate cancer).

What are the risks of a Prostate-Specific Antigen (PSA) Total test?

The PSA test itself has no specific risks—it is a simple blood test. However, the results of the test can lead to further procedures such as a biopsy, which has its own risks. The main risk associated with the PSA test is the potential for false positives or overdiagnosis.

Can the Prostate-Specific Antigen (PSA) Total test be done at home?

While most PSA tests are done in a clinical setting, there are home testing kits available for PSA. However, results from home tests should be confirmed and interpreted by a healthcare provider.

How does one prepare for a Prostate-Specific Antigen (PSA) Total test?

Typically, no special preparation is needed for a PSA test. However, because certain activities or conditions can influence PSA levels, your doctor might provide specific instructions about avoiding exercise or ejaculation for a period of time before the test.

Other Specific Questions

Why might a doctor recommend a free PSA test along with the Prostate-Specific Antigen (PSA) Total test?

A doctor might recommend a free PSA test if your total PSA results are in a borderline range (4 to 10 ng/mL). The results of the free PSA test can help give more information about whether your symptoms are due to cancer or a benign condition.

Can the Prostate-Specific Antigen (PSA) Total test be used to check for recurrence of prostate cancer?

Yes, following treatment for prostate cancer, regular PSA tests can be used to check for signs of recurrence. A rising PSA level may indicate that the cancer has returned.

How does a digital rectal examination (DRE) relate to a Prostate-Specific Antigen (PSA) Total test?

A DRE is another tool doctors use to check for prostate problems. During a DRE, the doctor manually checks the prostate for abnormalities. A DRE and a PSA test are often used together to screen for prostate cancer.

What is the role of Prostate-Specific Antigen (PSA) Total test in active surveillance of prostate cancer?

For some men with low-risk prostate cancer, active surveillance is a treatment option. This involves closely monitoring the cancer without active treatment. Regular PSA tests are a key component of active surveillance to detect any changes that might suggest the cancer is progressing.

Can Prostate-Specific Antigen (PSA) Total test be used in conjunction with other diagnostic tools?

Yes, the PSA test is often used in combination with other diagnostic tools such as a digital rectal exam (DRE), imaging tests, and a prostate biopsy to diagnose prostate conditions.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Also known as: PSA

Psa, Total

PSA stands for prostate-specific antigen. It is a protein produced by prostate cells. The PSA test is done to help diagnose and follow prostate cancer in men.
*Process times are an estimate and are not guaranteed. The lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

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