The Prostate Specific Antigen (PSA) test is a blood test which is Often used to screen for the presence of benign enlargement of the prostate and of prostate cancer. Though the test cannot in itself be used to diagnose these conditions it is an excellent indicator and, along with other tests, PSA scores can suggest the need for further investigation.
The test is generally recommended for men at particular risk (such as those with a family history of the condition) from the age of around 40 to 45 and for men in general after they reach 50 years of age.
An isolated test will provide a snapshot of of the level of prostate specific antigen in the blood and may show a problem straight away if you have an especially high PSA score. However, in the majority of cases, and when a prostate problem may be in its initial stages of development, a single test result will prove to be inconclusive and a follow-up test will usually be suggested in a few weeks time. Indeed, if possible testing should be done regularly 2 or 3 times each year so that PSA levels can be plotted over a reasonable period of time.
As long as you record a normal PSA score all is well, but when your PSA scores begin to increase they must be monitored closely. The speed with which PSA scores increase is usually called the 'PSA velocity' and as long as the increase is gradual and the velocity slow then it is once again frequently enough simply to monitor the situation as many things can influence PSA levels and seemingly increasing levels will frequently be seen to fall back to normal given time.
However, if PSA test readings begin rising rapidly and the velocity is high then further investigation is certainly necessary.
PSA testing and monitoring has been carried out for some considerable time but, despite the fact that the test has always been considered to be a good indicator of the requirement for further investigation, it was not until fairly recently that we have been in a position to link specific PSA velocity readings to prostate cancer in a fashion which can indicate the aggressiveness of a cancer.
In a study carried out recently data pertaining to 950 men who had been diagnosed with prostate cancer and undergone either surgery of radiation treatment at four hospitals between 1988 and 2004 was carefully scutinized.
In every case each patient had been diagnosed with aggressive prostate cancer on the basis of a single very high PSA reading, a noticeable increase in PSA velocity during the year before diagnosis, a biopsy indicating signs of an aggressive cancer at cellular level, the presence of an advanced stage tumor or a mix of two or more of these markers.
The study also looked in detail at the outcomes for all of the patients and found that a rapidly increasing PSA score which rose by 2 points or more in a twelve month period was the best indicator or the presence of an aggressive cancer.
Up until this point we have been able to associate increasing PSA test levels with an indication of the possible presence of prostate cancer but it has been necessary to guess to some extent about whether or not such a cancer might be aggressive and require correspondingly aggressive intervention.
However, now we can say with a fair degree of certainty that if a PSA score rises by 2 or more points in a year then prostate cancer is almost certainly aggressive and requires swift and vigorous treatment.
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