How to prepare for a PSA blood test. What factors can affect PSA levels. When should men consider getting a PSA test. What to avoid before taking a PSA test. How to interpret PSA test results.

Understanding PSA Blood Tests: Purpose and Importance

A Prostate Specific Antigen (PSA) blood test is a crucial tool in detecting prostate cancer. This test measures the level of PSA, a protein produced by the prostate gland, in a man’s blood. While it’s natural to feel anxious about taking a PSA test, understanding its purpose and how to prepare can help alleviate concerns.

Why is the PSA test important? It serves as an effective initial screening method for prostate cancer and helps monitor treatment effectiveness in those already diagnosed. The test’s significance lies in its ability to detect potential prostate issues before they become more serious.

Who Should Consider PSA Testing?

The U.S. Preventive Services Task Force recommends that men between 55 and 69 years old, with average risk, should consider PSA screening. However, certain factors may warrant earlier or more frequent testing:

• Men over 65 (PSA levels naturally increase with age)
• Individuals with a family history of prostate cancer
• African American men
• Overweight individuals
• Smokers
• Those leading a sedentary lifestyle or maintaining an unhealthy diet

Are there specific risk factors that necessitate earlier PSA testing? Yes, individuals with a family history of prostate cancer or those of African American descent may benefit from earlier screening due to their increased risk.

Preparing for Your PSA Test: Do’s and Don’ts

Contrary to some medical tests, a PSA blood test doesn’t require fasting. You can eat and drink as usual before the test. However, there are several important factors to consider in the days leading up to your PSA test to ensure accurate results.

Physical Activity and PSA Levels

Can exercise affect PSA levels? Yes, intense physical activity can temporarily elevate PSA levels. It’s advisable to avoid heavy exercise for a few days before your test. This includes activities like bicycling, riding motorcycles or ATVs, and horseback riding, which have been shown to cause slight, short-term increases in PSA levels.

Sexual Activity and PSA Testing

Does sexual activity impact PSA results? Indeed, recent ejaculation can cause a slight rise in PSA levels. To ensure accurate results, it’s recommended to abstain from sexual activity, including any form of ejaculation, for at least 48 hours before the test.

Medications and Supplements: Potential Impacts on PSA Levels

Certain medications and supplements can influence PSA levels, potentially affecting the reliability of your test results. It’s crucial to discuss your current medication and supplement regimen with your doctor before the test.

Which substances can affect PSA levels? The following may raise or lower PSA levels:

• Chemotherapy drugs
• Statins
• NSAIDs (nonsteroidal anti-inflammatories)
• Urinary health medications
• Supplements such as carnitine, fenugreek, pomegranate, saw palmetto, PC-SPES, lycopene, and phytoestrogens

Common Misconceptions About PSA Testing

There are several myths surrounding PSA testing that need clarification. Understanding these can help alleviate unnecessary concerns and ensure proper preparation for the test.

Alcohol and Caffeine Consumption

Do alcohol and caffeine affect PSA levels? Contrary to popular belief, alcohol and caffeinated drinks are not established risk factors for prostate cancer and do not directly affect PSA levels. However, heavy alcohol consumption may slightly increase the risk of more aggressive forms of prostate cancer. It’s important to note that alcohol, caffeine, and smoking do not cause false-positive elevations of PSA levels.

Urinary Tract Infections and PSA Testing

Can a urinary tract infection impact PSA results? Yes, urinary tract infections can potentially affect PSA levels. If you have a urinary tract infection or are taking antibiotics for one, it’s crucial to consult your doctor before proceeding with a PSA test. The same applies if you’ve recently experienced a pelvic injury or undergone prostate or urinary tract surgery.

Understanding Elevated PSA Levels: Causes and Implications

Elevated PSA levels can be concerning, but it’s important to understand that various factors can contribute to increased PSA levels, not just prostate cancer. What are the common causes of elevated PSA in men?

• Benign prostatic hyperplasia (BPH) – an enlarged prostate
• Prostatitis – inflammation of the prostate
• Urinary tract infection
• Recent prostate stimulation (e.g., digital rectal exam)
• Age (PSA levels naturally increase as men get older)
• Prostate cancer

It’s crucial to remember that an elevated PSA level doesn’t automatically indicate prostate cancer. Your doctor will consider various factors and may recommend additional tests to determine the cause of the elevation.

Innovations in PSA Testing: At-Home Options

Advancements in medical technology have made PSA testing more accessible. At-home PSA tests, such as the imawareâ„¢ PSA test, offer a convenient alternative to traditional clinical testing.

Benefits of At-Home PSA Testing

What advantages do at-home PSA tests offer? These tests provide:

• Convenience of testing from home
• No need for a physician’s note (approved by the test provider’s medical team)
• Quick turnaround time for results (typically within 7 days)
• Secure digital delivery of results
• Easy-to-understand results with both numerical values and qualitative analysis

While at-home tests offer convenience, it’s important to discuss the results with a healthcare provider for proper interpretation and any necessary follow-up.

Interpreting PSA Test Results: Next Steps

Receiving your PSA test results can be anxiety-inducing, especially if the levels are elevated. Understanding what your results mean and the potential next steps can help alleviate some of this worry.

Normal vs. Elevated PSA Levels

What constitutes a normal PSA level? Generally, PSA levels below 4.0 ng/mL are considered normal. However, there’s no universally agreed-upon cut-off point for “normal” PSA levels. Some men with PSA levels below 4.0 ng/mL can have prostate cancer, while many men with higher levels do not have cancer.

If your PSA levels are elevated, your doctor may consider several factors:

• Your age (PSA levels naturally increase with age)
• The degree of PSA elevation
• How quickly your PSA levels have changed over time (PSA velocity)
• Other risk factors for prostate cancer
• Results from a digital rectal exam

Follow-Up Procedures for Elevated PSA Levels

What happens if your PSA levels are high? Dr. Jeffrey Herz, MD of Halo Diagnostics explains: “Typically, an abnormal PSA level will result in a consultation with a urologist. The urologist may recommend additional tests such as a digital rectal exam, a prostate MRI, or a prostate biopsy to determine the cause of the elevated PSA.”

It’s important to remember that an elevated PSA level doesn’t necessarily mean you have prostate cancer. Your doctor will work with you to determine the best course of action based on your individual circumstances.

Prostate Health: Beyond PSA Testing

While PSA testing is an important tool for prostate cancer screening, maintaining overall prostate health involves more than just regular testing. What steps can men take to promote prostate health?

• Maintain a healthy diet rich in fruits, vegetables, and whole grains
• Exercise regularly
• Maintain a healthy weight
• Limit alcohol consumption
• Quit smoking
• Stay hydrated
• Manage stress

Regular check-ups with your healthcare provider, including discussions about prostate health, are crucial. These visits allow for early detection of any potential issues and provide an opportunity to address any concerns you may have about your prostate health.

The Role of Diet in Prostate Health

Can diet impact prostate health? Research suggests that certain foods may help maintain a healthy prostate:

• Tomatoes and tomato-based products (rich in lycopene)
• Cruciferous vegetables like broccoli, cauliflower, and cabbage
• Fatty fish high in omega-3 fatty acids
• Green tea
• Soy products

While no single food can prevent prostate cancer, a balanced diet rich in these foods may contribute to overall prostate health.

The Future of Prostate Cancer Screening

As medical research advances, new methods for prostate cancer screening are being developed. These innovations aim to improve the accuracy of diagnosis and reduce the need for unnecessary biopsies.

Emerging Technologies in Prostate Cancer Detection

What new technologies are being developed for prostate cancer screening? Some promising advancements include:

• Multiparametric MRI: Provides detailed images of the prostate, potentially reducing the need for biopsies
• PCA3 test: Measures the levels of prostate cancer antigen 3 (PCA3) in urine
• 4Kscore test: Combines the results of four prostate-specific kallikrein assays with clinical information
• ExoDx Prostate test: Analyzes exosomal RNA for three biomarkers associated with high-grade prostate cancer

These new technologies, used in conjunction with PSA testing, may help improve the accuracy of prostate cancer screening and reduce overdiagnosis and overtreatment.

Personalized Screening Approaches

How might prostate cancer screening evolve in the future? The trend is moving towards more personalized screening approaches. These take into account individual risk factors, genetic predisposition, and previous screening results to determine the most appropriate screening strategy for each man.

This personalized approach may help balance the benefits of early detection with the potential harms of overdiagnosis and overtreatment, leading to more effective and efficient prostate cancer screening practices.

How To Prepare For A PSA Blood Test & What To Avoid

Getting tested for Prostate Specific Antigen (PSA) can give anyone a little anxiety. It’s perfectly natural to have a lot of questions before you take a PSA blood test. How do you prepare for a PSA test? Is there anything I can do to make sure my results are accurate? What do the results mean?

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What is a PSA Blood Test?

The PSA blood test is one of the methods that physicians use to detect prostate cancer. The test is considered an effective start to the  prostate cancer screening process, and  a useful test to be used to monitor the effectiveness of treatment used for those being treated with prostate cancer. 

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Who Should Get a PSA Test?  

The current US Preventive Services Task Force states that men of an average risk of prostate cancer between the ages of 55-69 should consider being screened using a PSA test.  However, other individuals at a higher risk might want to be considered for earlier screening including: 

• Those who might be overweight
• Older men – those over 65 – as PSA rises over time, starting at age 50
• Those with a family history of prostate cancer
• African American men
• Smokers
• Those living a sedentary lifestyle, or those who eat an unhealthy diet

To learn more about screening for prostate cancer, visit Prostate Conditions Education Council.

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How Do You Prepare For a PSA Test? 

You do not need to fast from food or drink before taking a PSA test. There are currently no foods or beverages to avoid before taking a PSA test. While some foods might be linked to prostate conditions, no scientific evidence links the consumption of one food to elevated PSA levels. There is no need to avoid certain foods, coffee or alcohol before taking a PSA test. 

What Should I Avoid Before a PSA Test? 

Can I work out before I take a PSA test? 

While physical activity in general might help maintain a normal prostate, avoid heavy exercise directly before your PSA. Avoid exercise for a few days before your PSA test. Even bicycling, riding motorcycles or ATVs, or riding horses have been shown to elevate PSA slightly for a short period of time.. 

Can I have sex before I take a PSA test?

No. You should abstain from sexual activity – anything that includes ejaculation – for at least 48 hours before the test. A recent ejaculation might cause a slight rise in PSA levels.  

What about supplements and medications?

The following supplements or medications may have an affect on your PSA levels and should be discussed with your doctor. They may raise or lower your PSA and might not create a reliable test result: 

• Chemotherapy drugs
• Statins
• NSAIDS (nonsteroidal anti inflammatories) 
• Urinary health medications
• Carninte, fenugreek, pomegranate, saw palmetto, the herb PC-SPES, lycopene, and phytoestrogens. 

Can alcohol or coffee consumption skew results?

Alcohol and caffeinated drinks are not established risk factors for prostate cancer and will not affect PSA levels. However, it is understood that heavy alcohol drinking could cause a small risk of more aggressive forms of prostate cancer. The bottom line here is that alcohol, caffeine and smoking do not cause  false-positive elevations of PSA levels.

I have a urinary infection, is that a problem?

‍Please consult your doctor if you have a urinary tract infection or if you are taking antibiotics for a urinary tract infection. Please also consult a physician before taking a PSA test if you have recently suffered a pelvic injury or have had prostate or urinary tract surgery. 

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What Can Cause Elevated PSA Levels?

The most common causes of elevated PSA in men

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What Makes the imaware™ PSA Test Unique?

While we use the same total PSA biomarker that other tests use, our at-home imaware™ PSA test is unique as it can be done in the comfort of your own home. It can also be ordered without a physician’s note, as imaware™ has a team of physicians that approve all orders and results for patients. Your PSA test results are delivered to a secure patient portal and are easy to download for your next doctor appointment. Getting a PSA test is easy with imaware™.  

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Results of a PSA Blood Test

With imaware™, you’ll receive your results within 7 days of shipping the sample off to our labs. You’ll receive an email prompting you to log into your secure patient portal to view your results. Your results will give you a detailed look at your total PSA biomarker. Not only will the results give you a numerical value, but also a qualitative look into your data, taking into account any provided risk factors. 

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What if my PSA levels are considered high?

If your test shows an increased PSA level, please consult your physician for further diagnosis. To help give you an idea of what your physician may do next to help you, here’s a quote from Dr Jeffery Herz, MD of Halo Diagnostics:

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“Typically, an abnormal PSA level will result in a consultation with us which often involves obtaining a family history of prostate cancer, a complete medical/surgical history including current medications, a discussion regarding voiding status, evaluation of previous PSA levels (PSA history), consideration of further evaluation including possible repeat PSA tests and the need for possible prostate biopsy”

Jeffery Herz, MD | Board Certified Urologist, HALO Dx

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If you’re interested in learning more about the innovative diagnosis and treatment techniques for prostate cancer, visit our partners at Halo Diagnostics to learn more about multiparametric prostate MRI (mpMRI) and laser focal therapy.

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Frequently Asked Questions about the PSA Blood Test | Roswell Park Comprehensive Cancer Center

As we grow older, our risk of developing serious health issues, including cancer, also grows. For men, the risk of getting prostate cancer increases with age. Prostate cancer is rare in men under 40, and about 60% of cases are diagnosed in men aged 65 or older. But in the United States, nearly one of every nine men will be diagnosed with the disease. That’s why doctors recommend screening for prostate cancer beginning at age 45, with a yearly digital rectal exam and PSA blood test.

But what is exactly is a PSA test and what does it measure? When should you consider starting your screening for prostate cancer? We’ve compiled answers to these and other frequently asked questions about PSA tests here.

What is a PSA test?

Prostate-specific antigen (PSA) is a protein produced by the prostate gland that is present in small quantities in all men’s blood. It often is elevated in the presence of prostate cancer, making a man’s PSA levels a useful tool for early prostate cancer detection.

The PSA blood test was developed at Roswell Park Comprehensive Cancer Center in the 1970s and is now in use worldwide. Since the test was first introduced, the cure rate for prostate cancer has increased from about 4% to 80%. Here are some answers to the frequently asked questions we receive from men preparing for their first PSA exam.

How is the PSA test done?

A PSA test is performed the same way as other routine blood tests. A small vial of blood is drawn from the arm and brought to a laboratory where PSA levels are measured as the number of nanograms (ng) in each milliliter (mL) of blood tested.

What is a normal PSA value?

A PSA level between 2.5 and 4 ng/mL is considered a normal PSA level for most men, but this depends on many factors, such as the patient’s age, prostate size and a variety of patient activities (for example, bike riding).  A PSA level greater than 4 ng/mL may be normal for some men.  A physician must interpret whether the PSA level is normal for each individual.

What does a PSA test do?

As mentioned above, a PSA test measures the amount of prostate-specific antigen (PSA) found in a man’s blood. Many factors including prostate cancer can cause someone’s PSA levels to rise. A PSA test is designed as an early detection and monitoring screening tool for prostate cancer.

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Do you have to fast for a PSA test?

No, fasting is not required before a PSA test.

When should a man start PSA testing?

Roswell Park follows PSA screening guidelines established by the National Comprehensive Cancer Network (NCCN), which brings together world-renowned experts from 30 of the nation’s top cancer centers to write guidelines that specify the best ways to prevent, detect and treat cancer.

Current guidelines include recommendations to start PSA screening at age 40 if you are African-American, or if you have a father or brother who had prostate cancer — especially if they were younger than 60 at the time of diagnosis — or if you have undergone genetic screening that showed you have a genetic mutation (such as BRCA1, BRCA2, ATM, HOXB13, MLh2, MSh3 or MSH6).

If you do not fall into any of the groups above, you may consider beginning early detection with a baseline PSA test and digital rectal exam at age 45. The results of these tests will be used to compare with future tests. If your first PSA test shows a level of 1.0 ng/mL or higher, you should undergo follow-up testing every one to two years. If your first PSA test shows a level less than 1.0 ng/mL, you should have follow-up testing every two to four years.

A PSA test is generally not recommended for men over the age of 75 unless they are very healthy and have a life expectancy of 10 years or more.

You should discuss the pros and cons of having a PSA test with your doctor. If you do receive a PSA test, your doctor will need to put the results in perspective with your age, how long you can be expected to live, your family medical history, your race and the results of any previous PSA tests.

PSA, Take a blood test for PSA general

Method of determination
Chemiluminescent immunoassay.

Test material
Blood serum

Home visit available

Online check-in

Total PSA is a protein specific to prostate tissue used as a tumor marker. Physiological excretory product of the prostate.

Synonyms: General PSA blood test; Prostate-specific antigen is common.

Prostate-specific antigen total; Human PSA total.

Test summary PSA generic

Prostate specific antigen is a 34 kDa glycoprotein produced by both normal and malignant prostate cells. PSA is produced mainly by the epithelial cells of the prostate gland and is secreted into the seminal fluid in small amounts. It has enzymatic (protease) activity, reducing the viscosity of the ejaculate and increasing sperm motility. PSA is found in normal prostate tissue, metastatic prostate cancer adenomas, prostatic fluid, and seminal plasma, but is not present in other normal or malignant human tissues. PSA is widely used in the diagnosis of prostate cancer, as well as to detect its metastases. In addition to prostate cancer, elevated PSA levels in men can cause a number of benign conditions, which include prostatitis and benign prostatic hyperplasia. The half-life is about four days. In the blood serum, prostate-specific antigen is contained in two forms – free and associated with various proteinase inhibitors. The content of the free form (f-PSA) is about 10% of the total amount of PSA. Most of the PSA (90%) is associated with alpha1-antichymotrypsin and is available for laboratory determination. A small part of the prostate antigen is associated with alpha2-macroglobulin and is not available for examination by conventional methods, since the PSA molecule is located inside the complex. The free and bound fractions make up the total PSA. The content of total PSA normally increases with age, but should not exceed 4 ng / ml. Any mechanical irritation of the gland can lead to a significant increase in the concentration of PSA in the blood serum. Elevated PSA concentrations (up to 10 ng / ml) are observed in some benign prostate tumors. In the presence of prostate carcinoma, PSA is present in the blood serum, mainly in a bound form. Therefore, the ratio of free and total PSA decreases and is usually less than 15%.

Measuring free PSA and determining the free PSA/total PSA ratio is especially important in the case of a slight increase in total PSA in the range from 4.0 to 10.0 ng/ml at concentrations close to the upper limit of the reference values. In benign prostatic hyperplasia, the ratio of the free fraction and the total immunoreactive prostate-specific antigen is more than 15%. Increasing or persistently elevated PSA concentrations, determined during the observation of the patient, indicate tumor growth and the ineffectiveness of therapy or surgical intervention. The decrease in PSA values, determined during the observation of the patient, indicates a positive therapeutic effect. A PSA value above 30 ng/ml usually indicates the presence of a malignant neoplasm. In patients with severe prostate cancer and metastases, a concentration of 1000 ng / ml and above was noted.

When monitoring treatment, it is better to compare the PSA concentration with the patient’s previous serum concentration readings, rather than with reference values.

What is the purpose of determining the level of total PSA in blood serum?

Determination of the PSA level is carried out in monitoring the course of the disease, preclinical diagnosis of metastasis, to assess the effectiveness of the therapy of prostate carcinoma, in monitoring the condition of patients with prostate hypertrophy in order to detect early prostate carcinoma.

Screening for men over 50 years of age and over 45 years of age with a family history includes monitoring for changes in prostate specific antigen levels.

What can affect the result of a total PSA test

It is important to consider that an increase in PSA levels can be up to three weeks after a biopsy, prostatectomy or prostate massage. To eliminate errors, the determination of free and total immunoreactive PSA (with the calculation of their ratio) should be carried out by one method and from one blood sample. Subsequent monitoring is preferably carried out using the same method and preferably in the same laboratory.

PSA, Take a blood test for PSA general

Method of determination
Chemiluminescent immunoassay.

Test material
Blood serum

A protein specific to prostate tissue used as a tumor marker. Physiological excretory product of the prostate.

Glycoprotein with a molecular weight of 34 kDa. It has enzymatic (protease) activity, reducing the viscosity of sperm. Contained in the cytoplasm of the epithelial cells of the ducts of the prostate. PSA is found in normal prostate tissue, adenomas and metastases of prostate cancer, prostatic fluid, and seminal plasma, but is not present in other normal or malignant human tissues.

The half-life is 4 days. In the blood serum, prostate-specific antigen is contained in two forms – free and associated with various antiproteases. The content of the free form (f-PSA) is about 10% of the total amount of PSA.

Most of the PSA (90%) is associated with alpha1-antichymotrypsin and is available for laboratory determination. A small part of the prostate antigen is associated with alpha 2-macroglobulin and is not available for examination by conventional methods, since the PSA molecule is located inside the complex. The free and bound fractions make up the total PSA.

The content of total PSA normally increases with age, however, should not exceed 4 ng / ml. Any mechanical irritation of the gland can lead to a significant increase in serum PSA concentration.

Elevated PSA concentrations (up to 10 ng / ml) are observed in some benign prostate tumors. In the presence of prostate carcinoma, PSA is present in the serum, mainly in a bound form. Therefore, the ratio of free and total PSA decreases and is usually less than 15%. Measurement of free PSA and determination of the free PSA/total PSA ratio is especially important in the case of a slight increase in total PSA in the range from 4.0 to 10.0 ng / ml, at concentrations close to the upper limit of the reference values.

In benign prostatic hyperplasia, the ratio of the free fraction and the total immunoreactive prostate-specific antigen is more than 15%. Increasing or persistently elevated PSA concentrations, determined during the observation of the patient, indicate tumor growth and the ineffectiveness of therapy or surgical intervention.