FAQ

PSA means prostatic specific antigen.

PSA is a chemical substance (like an enzyme) that is being produced from the prostate cells and enters the blood stream. PSA is nowadays a useful weapon at the urologist’s diagnostic armamentarium.

Every man over the age of 40, should have his PSA controlled once a year. The PSA normal values are between 0-4 ng/ml. A PSA elevation must always be evaluated and diagnosed further.

However a PSA elevation does not guarantee a prostate cancer. PSA can be elevated when a patient has a very big prostate gland (benign prostate hyperplasia), a prostate infection, or retention. A catheter placed through the urethra can also cause a PSA elevation, as well as the DRE (the finger examination that the urologist performs) or the ultrasound examination through the anus, therefore the blood has to be taken before the examination takes place. Even exercise that puts pressure upon the perineum, like cycling, can lead to a PSA elevation. When those situations are relieved, the PSA falls back.

When the PSA is elevated the urologist must examine the prostate gland with his finger through the anus. If a suspicious finding comes forth, a prostate biopsy will have to be performed. Only the prostate biopsy can exclude the diagnosis of a prostate cancer.

Attention! There are however cases of patients with prostate cancer, while having a normal PSA value!

By elder patients and in the case of a very big prostate gland the PSA is expected to be 2-3 times higher than normal. By those cases, it is important to follow the PSA dynamic, which means how much and how fast the PSA value changes with the time.

By patients who have their prostate removed due to prostate cancer or for those who are under a hormone treatment the PSA plays a good sufficient prognostic role. The PSA value after a radical prostatectomy at patients without a metastatic disease should be under 0,1 ng/ml.

Do not be panicked if you are diagnosed with an elevated PSA. The elevated PSA is not a synonymous to prostate cancer and a normal PSA value on the other side can not exclude a prostate cancer. Visit your urologist and let him examine your prostate. If you are a man over 40 years old, let your PSA controlled once a year.