PSA numbers and how to understand them
What should the PSA level be? Before considering certain numbers, please note: If a man’s PSA is higher than these numbers, this does not necessarily mean that it has prostate cancer. There are other factors that can increase the PSA, which we will briefly cover. I have a lot more for PSA here, and of course, to book.
- For men in their 40s and 50s: A PSA score greater than 2.5 ng/ml is considered abnormal. The median PSA for this age range is 0.6 to 0.7 ng/ml.
- For men of the 1960s: A PSA score greater than 4.0 ng/ml is considered abnormal. The normal range is between 1.0 and 1.5 ng/ml.
- An abnormal rise (the pace and speed of change in PSA is called PSA speed): A PSA rating can also be considered abnormal if a certain amount is increased in a single year. For example, if a man’s PSA rating increases more than 0.4 ng/ml in a single year, he must learn why. If his PSA goes up and down, but he is even higher than he should be, he has to know why.
Men: If you are in your 40s and your PSA level is greater than 0.6 ng/ml or if you are in the 50’s and your PSA is greater than 0.7, you should count your PSA at least every two years. If your PSA is under that, you might be able to wait as five years for the next test.
To older men, Benign prostate enlargement (called BPH) can also increase the PSA number. BPH is very common: they are in 50 % of men in the 1950s, 60 percent of men in the 1960s, 70 percent of men in the 1970s, etc. Note: Medicines for the treatment of BPH CAN artificially lower PSA up to half. Taking a 5-alpha-reductase inhibitor, such as Finasteride (Prescar) or Dutasteride (Avodart) for the treatment of BPH or Propecia drug, used to prevent hair loss (low-dose finasteride) can reduce PSA artificially. If a man has taken one of these medicines for a short time, his PSA number must be doubled. If it has taken it for five years or more, its PSA should be multiplied by 2.5. Don’t just take this low score in the nominal value.
Here are more PSA numbers than the book,adapted by Journal of the American Medical Union:
How many men have this PSA level?
2.5 or lower: 88 percent of men in the 1950s, 75 percent of men in the 1960s and 61 percent of men aged 70 or more.
2.6-4.0: 8 percent of men in the 1950s. 14 % of men in the 1960s and 18 % of men aged 70 or more.
4.1-9.8: 3 % of men in the 50’s. 9 % of men in the 1960s and 16 % of men aged 70 or more.
10 or higher: 1 percent of men in the 1950s. 2 % of men in the 1960s and 5 % of men aged 70 or more.
All this said, a PSA rating itself is not enough, because other things can increase the PSA. That is why it gets this base line and then watch what the PSA is doing over time is so important. This is PSA speed: Watching what PSA is doing.
What else can PSA increase?
Here’s a tip: Do PSA Blood Test before The examination of the rectum In the annual natural. The rectum exam, when the doctor pushes the prostate to check for any signs of hardness or pellets, may Why the PSA will be released in the bloodstream – Technological increases in PSA number. (Event of fun: Who is the patron who is supposed to feel like? Feel the pillow at the base of your thumb. The prostate must feel a bit squishy like that.)
Similarly, So he can have sex. Therefore a man must Avoid sexual activity for three days before blood test.
Prostatitis can also increase PSAsometimes at high levels. This is not cancer; It is inflammation in the prostate and is therapeutic. I have good information on prostatitis and pelvic pain syndrome here.
Second line tests shed light on the dark!
Fortunately, there are second -line blood and urine tests that can help to figure out if an elevated PSA number comes from BPH or prostate cancer.
I have a lot more for these tests here, but in short: Discolored tests Like the 4K index or prostate health index (PHI), look “free psa. “PSA comes in various forms. the highest percentage of the PSA which is freethe more likely you are to be cancer free. This test provides context: If the percentage of free PSA is higher than 25, then the increased PSA is more likely to be due to BPH, benign prostate enlargement. If it is lower than 25 percent, this does not automatically mean that there is cancer, but increases the likelihood of cancer. The 4K and Phi tests are even more useful than the free PSA test because they also look for biomarkers of aggressive cancer and put them all together in a score.
What if these things show cancer? Is the next step biopsy? No, it is the magnetic resonance imaging of the prostate.
I have written about it here, but basically, the result of prostate magnetic resonance imaging is called Pi-Rads rating, ranging from 1 to 5. A score of Pi-Rads 3 or higher is the trigger for a biopsy.
This biopsy should be MRI fusion biopsyWhere the MRI image is combined with transrestal ultrasound to give the doctor the best view of any suspicious areas that really need to be checked. In biopsy, 12-14 hollow core needles are used to take samples or cores, tissue. Note: A biopsy is not perfect. Each needle only samples 1/10,000th prostatic! In the book I have said that it is like looking for with A needle in a straw. That is why second -line tests can help paint a more complete picture of what is happening to the prostate.
There are two ways to make biopsy: through the transrest and through the perineum, the skin area between the rectum and the scrotum. If you are thinking of the prostate as about the size of a golf ball, the transparency approach basically goes from south to north. The transnetic approach goes from east to west, and makes a Much better work to find off -road cancer. I have written about it here. Not only is it more effective: there is zero risk of infection. There is no need for antibiotics! It is also better for diabetic men, who are at greater risk of getting an infection. The permeable approach, because it passes through the rectum, includes antibiotics. There is no one to take around him. The rectum is full of bacteria. Transperineal is the best way to go.
Since this order is about the control and detection of cancer, I will leave it here and will not be treated. This is covered throughout the website and, if interest, will be the subject of another series. Soon, if the cancer is found, you will be given a Gleason or Gleason Group rating. Cancer can range from a very low, low and favorable intermediate risk – which may never need treatment – in an unfavorable intermediate, high and very high risk. You will also be given a clinical stage, which is the assessment of how much cancer there is – or limited to the prostate (the most common scenario in the US today due to sorting). Either it has spread locally, but does not appear to exist in remote locations (shown by imaging). Or rarely, less than 10 percent of the time, either cancer has spread to lymph nodes or bones. Whatever the finding, don’t be discouraged! There is more hope now than ever.
In addition to the book, I have written about this story and much more about prostate cancer on the prostate cancer website, Pcf.org. The stories I wrote are under the categories, “understanding prostate cancer” and “for patients”. As we have said for years Patrick Walsh; Knowledge is power: Saving your life can start with the transition to the doctor and know the right questions you need to ask. I hope all men put prostate cancer on their radar. Take a basic PSA blood test in the early 1940s and if you are African descent or if the cancer and/or prostate cancer runs to your family, you should regularly examine for the disease. Many doctors do not do this, so it is up to you to ask for it. NOTE: I am a subsidiary of Amazon, so if you click on the link and buy a book, I will theoretically make a small amount of money.
© Janet Farrar Worthington