What Does an Elevated Prostate-Specific Antigen (PSA) & How to Lower the PSA Test Result?

In recent years, prostate cancer has become one of the most common types of cancer affecting men. The prostate gland is located just beneath the bladder and is involved in the production of semen. Prostate cancer is a bit difficult to diagnose as this type of cancer grows very slowly and remains within the gland itself. In advanced cases, however, prostate cancer can spread beyond the prostate gland as well. Advanced prostate cancer also grows more quickly. There are many treatment plans available for prostate cancer. Determining the best form of treatment depends on the stage of prostate cancer, PSA level, tumor grade, the age of the patients, and of course, other health issues affecting the patient.

Today we take a look at what are PSA levels and how are relevant these levels are when it comes to treating prostate cancer. PSA stands for prostate-specific antigen. The PSA is a basic blood test that can be useful to detect prostate cancer. The Prostate-Specific Antigen (PSA) test is also used to monitor the treatment and to assess the recurrence of prostate cancer as well. Now, what exactly is PSA? Prostate-Specific Antigen (PSA) is a chemical that is produced by not just cancerous tissues in the prostate, but also by noncancerous prostate tissues. Generally, Prostate-Specific Antigen (PSA) is found in low amounts in the blood. However, if the Prostate-Specific Antigen (PSA) level is found to be high for your age or is found to be increasing steadily, then it indicates that further investigation is required. Following the results of a Prostate-Specific Antigen (PSA) test, a prostate biopsy is usually recommended to determine the presence of prostate cancer or other abnormal cells.

What is Prostate-Specific Antigen (PSA) and What Is Its Role In Detecting Prostate Cancer?

Prostate-specific antigen (PSA) is one of the substances that is measured through a blood test in order to determine the likelihood of whether or not you have prostate cancer. Prostate-specific antigen (PSA) is a substance that is produced only by some specific cells in the prostate gland. It is released by the prostate gland into the semen. Inside the semen, the role of PSA is to liquefy the semen following ejaculation. Generally, the majority of the PSA which is produced by the prostate gland gets carried out of the body within the semen itself. However, a very small amount of PSA usually escapes into the bloodstream. Therefore, Prostate-specific antigen (PSA) is found in very low amounts in the blood. A healthy person should have only a small amount of PSA being circulated in the blood. In women, Prostate-specific antigen (PSA) has been found in some breast tissue, though the amount is nearly negligible to indicate anything.

How is PSA Measured?

The levels of Prostate-specific antigen (PSA) in the blood can be measured by a blood test. This test does not require any fasting or special preparations to be done. Due to the fact that the amount of Prostate-specific antigen (PSA) present in the blood is very low, it is only possible to detect PSA through a very sensitive type of technology known as the monoclonal antibody technique. The PSA protein can also exist in the blood as free PSA, meaning it is not bound to other substances. It can also be present in a bound state with other substances. This is known as complexed or bound PSA. Prostate-specific antigen (PSA) usually bounds to three substances – albumin, alpha-2-macroglobulin, and alpha 1-antichymotrypsin (ACT). So when the test measures the amount of PSA, it is actually measuring the sum of the free and bound forms of Prostate-specific antigen (PSA).

Recently, a new precursor of Prostate-specific antigen (PSA) known as proenzyme PSA ([-2] proenzyme PSA) has been identified. It is expected that this precursor will help in determining the risk of prostate cancer in men who have a PSA level of under 10, combined with a normal digital rectal examination. Please note that the PSA test has to be performed in conjunction with a digital rectal exam (DRE).This has been added as a newly approved test for measuring the amount of total Prostate-specific antigen (PSA).

What Does an Elevated Prostate-specific Antigen (PSA) Level Indicate?

A breakdown or disruption of the prostate cellular structure causes Prostate-specific antigen (PSA) to be released into the bloodstream, thus elevating the level of Prostate-specific antigen (PSA) in the blood. The reason behind why this happens is not really clear or understood. An elevated level of Prostate-specific antigen (PSA) occurs in the case of different prostate conditions including prostate cancer, but not limited to a cancerous reason only. PSA can also be elevated because of noncancerous causes. Keep in mind that Prostate-specific antigen is not specific to prostate cancer, but to prostatic tissue. Therefore, elevated Prostate-specific antigen (PSA) levels indicate the presence of some sort of prostate disease. Some of the more common and benign causes of Prostate-specific antigen elevation include BPH, which is an age-related enlargement of the prostate, prostatitis, an infection, or even benign prostatic hyperplasia.

Apart from this, any kind of prostate manipulation such as prostate examination, ejaculation, medical instrumentation, catheter placement, prostate biopsy or even urinary retention, may lead to an elevated level of Prostate-specific antigen Vigorous exercises that affect the prostate can also increase PSA. Bicycling is one such example. Due to these reasons, patients who have been recommended a PSA testing need to abstain from sex for a day or two prior to the testing. Men thinking about undergoing Prostate-specific antigen (PSA) testing need to be aware of these factors as they will influence the test results. Age and prostate volume are also known to influence Prostate-specific antigen (PSA) test results.

What Do Normal PSA Result Looks Like?

There is a debate over what normal PSA test results look like. For laboratory readings, however, the PSA serum concentration should be lower than 4 ng/mL. With increasing age, the prostate gland tends to increase in size naturally. Therefore, it is usually seen that younger men have a lower level of Prostate-specific antigen (PSA), while the levels increase in older men. Due to these age-related changes in Prostate-specific antigen (PSA) levels, the test has age-adjusted normal levels that are recommended and tested against. Ethnicity and family history of prostate cancer also plays a role in determining a normal PSA level. Doctors usually use a normal increase of lower than 0.75 ng/mL to determine if the Prostate-specific antigen (PSA) test results are suggestive of a disease. An increase in the levels from 0.5-2.5 ng/mL in a man between the ages of 50 to 59 years could be indicative of prostate cancer, in spite of what the normal value is. The size of the prostate gland also affects the PSA level.

How to Lower the PSA Test Result?

Having elevated PSA test results is not something you should panic over. There are many ways in which you can decrease your PSA levels. Medications that treat benign enlargement of the prostate can help reduce PSA levels by nearly 50% within just six to 12 months of use. Some of these medications include finasteride (Proscar), dutasteride (Avodart), a combination of tamsulosin (Jalyn) and dutasteride, etc. Even herbal supplements that contain phytoestrogens and saw palmetto are known to lower the levels of PSA. It is important that you do not take any medications without consulting your doctor. Also, if you are taking any medication to lower your Prostate-specific antigen (PSA) levels, then make sure to inform the same to your doctor.

What Conditions Affect the Levels of Prostate-specific antigen (PSA)?

Certain conditions related to the prostate gland can also cause the gland to produce higher levels of PSA. These include:

  • Benign prostatic hyperplasia (enlarged prostate).
  • Prostatitis.
  • Prostate cancer.

How Accurate is a PSA Test in Detecting Prostate Cancer?

There are some limitations to the PSA test because PSA is not only specific to prostate cancer. The levels of PSA in the blood can be impacted by many other common conditions as described above. The PSA test results can also be impacted by the use of different testing equipment. A research study showed that nearly 1 in 4 men who had a PSA result that was above normal, tested normal when the test was repeated.

It is also not necessary that anybody who has an elevated level of PSA will be diagnosed with prostate cancer. In fact, only 25% of men having elevated PSA results between 4 ng/mL and 10 ng/ML will be diagnosed with prostate cancer following a prostate biopsy.

The PSA test has a low specificity in detecting prostate cancer. There is also an attached inability of the test to determine whether it is an aggressive form of cancer or one that is unlikely to cause harm. The test results, therefore, often leads to overtreatment in about 50% of men suffering from prostate cancer.

Conclusion

While the PSA test is a useful tool for men who are at a high risk for prostate cancer, such as African Americans, or even those who have a family history of prostate cancer. Before going ahead with the PSA test, you should understand both the risks and benefits of the test. However, in spite of the limitations of the PSA test, it still remains an important tool for monitoring and detecting prostate cancer. A PSA test can also assess your body’s response to the ongoing prostate treatment.

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