Your PSA Test: Keep Score
Focused on Health - September 2010
by Adelina Espat
“Should I or should I not get a PSA test?” This is the question most men are asking after recent reports debate the usefulness of this prostate exam.
“Men should not write off the PSA test,” says John W. Davis, M.D., assistant professor in MD Anderson’s Department of Urology. “It is still an effective way to track trends in your prostate over time. Doing this increases the chances that your doctor will find prostate cancer as early as possible.”
Davis urges men to keep a record of all their PSA test results to discuss with their doctor.
“Reviewing your PSA results over the past four or more years – instead of a one-time number – can help your doctor determine whether you are more likely to get prostate cancer.”
Most men age 50+ should get tested
The prostate specific antigen, or PSA, test is a simple blood test. It measures the amount of PSA in a man’s bloodstream. PSA is a protein produced by the cells of the prostate gland.
MD Anderson recommends that men age 50 and older, with no family history of prostate cancer, get a prostate cancer screening exam every year. African-American men and men with a family history of prostate cancer should begin annual screening exams at age 45. Both a digital rectal exam and a PSA blood test should be performed.
Recent guidelines by the American Cancer Society stress that men also should talk to a doctor before getting tested. A doctor can explain the possible benefits and risks of prostate cancer screening and treatment.
Tips for tracking your PSA levels
“If you decide to do the PSA test after talking to your doctor, start tracking your PSA levels as soon as you begin testing,” Davis says.
He suggests the following tips when recording PSA test results:
- Download our PSA tracking tool. It’s an easy way to track your PSA levels. Use it to start a discussion with your doctor.
- Note the testing standard used to find your PSA level each year. Knowing the testing standard helps doctors compare measurements from one year to the next.
- Ask your doctor for the actual PSA number. Don’t just record the results as normal or elevated.
“Lower PSA levels may suggest you have a lower risk for prostate cancer,” Davis says. “But, a low number, or normal result, does not mean you will not get the disease. This is why tracking trends over time, even among normal results, is so important.”
Monitor PSA trends
When monitoring trends in your PSA levels, Davis suggests looking for these warning signs:
- Doubled PSA score: Has your score doubled in a year?
- Velocity (or speed of increase over time):The amount of PSA in the blood is measured in nanograms per milliliter. A greater than 0.35 nanograms increase over time is linked to a higher risk for prostate cancer.
- High PSA score: Between 2.5 to 4 nanograms is considered high and may put you at increased risk.
Other factors increase risk
“Your doctor also should consider other factors that may increase your chances for developing prostate cancer,” Davis says.
Factors that affect overall risk include:
- Race: African-Americans get prostate cancer twice as often as white men.
- Family history: Your risk is higher if your brother, son or father had prostate cancer.
- Age: As you get older, your risk for prostate cancer increases.
- Abnormal digital rectal exam: An abnormal exam result increases your risk for prostate cancer.
“Remember, not every man should get a PSA test,” Davis says. “Starting at age 40, however, all men should talk to their doctor about this test. Your doctor can help you decide whether or not the PSA test is right for you as well as when to begin testing.”