What is a PSA blood test and who should get one. How to prepare for a PSA test and what to avoid before the test. What can cause elevated PSA levels and how to interpret test results.

Understanding PSA Blood Tests: Purpose and Importance

A Prostate Specific Antigen (PSA) blood test is a crucial tool in detecting prostate cancer and monitoring treatment effectiveness. But what exactly is a PSA test?

A PSA test measures the level of prostate-specific antigen in the blood, a protein produced by the prostate gland. Elevated levels may indicate prostate cancer, although other factors can also cause increased PSA levels.

Who should consider getting a PSA test? The U.S. Preventive Services Task Force recommends that men between 55 and 69 years old with average risk should discuss PSA screening with their healthcare provider. However, certain groups may benefit from earlier screening:

• Men who are overweight
• Men over 65, as PSA levels naturally rise with age
• Those with a family history of prostate cancer
• African American men
• Smokers
• Individuals with sedentary lifestyles or poor diets

Preparing for Your PSA Test: Key Considerations

Proper preparation is essential for accurate PSA test results. Contrary to some beliefs, fasting is not necessary before a PSA test. You can eat and drink as usual without affecting the outcome.

However, there are several important factors to consider in the days leading up to your test:

Physical Activity and PSA Levels

Can you exercise before a PSA test? It’s best to avoid strenuous physical activity for a few days prior to the test. Even activities like bicycling, riding motorcycles, ATVs, or horses can temporarily elevate PSA levels. Moderate exercise is generally fine, but consult your healthcare provider for specific recommendations.

Sexual Activity and PSA Testing

Should you abstain from sexual activity before a PSA test? Yes, it’s advisable to avoid any sexual activity that includes ejaculation for at least 48 hours before the test. Recent ejaculation can cause a slight increase in PSA levels, potentially affecting the accuracy of your results.

Medications and Supplements: Potential Impact on PSA Levels

Certain medications and supplements can influence PSA levels, potentially leading to unreliable test results. It’s crucial to discuss your current medication and supplement regimen with your healthcare provider before the test. Some substances that may affect PSA levels include:

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

Your doctor may advise you to temporarily discontinue certain medications or supplements to ensure accurate test results.

Lifestyle Factors and PSA Testing: Debunking Common Myths

Many people wonder about the impact of common lifestyle factors on PSA test results. Let’s address some frequent concerns:

Alcohol and Caffeine Consumption

Do alcohol and coffee affect PSA levels? Contrary to popular belief, moderate alcohol and caffeine consumption do not significantly impact PSA levels or cause false-positive elevations. However, heavy alcohol consumption may slightly increase the risk of more aggressive forms of prostate cancer.

Smoking and PSA Levels

While smoking is a risk factor for various health issues, it does not directly cause false-positive elevations in PSA levels. However, quitting smoking is always beneficial for overall health and may reduce the risk of prostate cancer progression.

Medical Conditions and PSA Testing: When to Consult Your Doctor

Certain medical conditions can affect PSA levels or the testing process. It’s essential to inform your healthcare provider if you have:

• A current urinary tract infection
• Recently taken antibiotics for a urinary tract infection
• Suffered a recent pelvic injury
• Undergone prostate or urinary tract surgery

These factors may influence your PSA levels or require postponing the test to ensure accurate results.

Understanding Elevated PSA Levels: Causes and Implications

What can cause elevated PSA levels? While an increased PSA level may indicate prostate cancer, it’s important to note that other factors can also contribute to higher PSA readings:

1. Benign prostatic hyperplasia (BPH) – an enlarged prostate
2. Prostatitis – inflammation of the prostate
3. Recent ejaculation
4. Urinary tract infection
5. Prostate injury or trauma
6. Certain medical procedures, such as a prostate biopsy or catheterization

If your PSA levels are elevated, your healthcare provider will likely recommend additional tests to determine the underlying cause.

Interpreting PSA Test Results: What Do the Numbers Mean?

Understanding your PSA test results is crucial for proper follow-up care. PSA levels are typically measured in nanograms per milliliter (ng/mL) of blood. While there’s no definitive “normal” PSA level, here are some general guidelines:

• 0 to 2.5 ng/mL: Generally considered normal for men under 50
• 2.6 to 4 ng/mL: Normal for men 50-59 years old
• 4.1 to 6.5 ng/mL: Normal for men 60-69 years old
• 6.6 to 7.5 ng/mL: Normal for men 70 years and older

However, it’s important to note that these ranges are not definitive, and individual factors must be considered. Your healthcare provider will interpret your results based on your age, overall health, and risk factors.

PSA Velocity and Doubling Time

In addition to absolute PSA levels, doctors may consider PSA velocity (how quickly PSA levels change over time) and PSA doubling time (how long it takes for PSA levels to double). These factors can provide valuable insights into prostate health and potential cancer risk.

Next Steps After Receiving PSA Test Results

What happens if your PSA levels are considered high? If your test shows an increased PSA level, your healthcare provider will likely recommend further evaluation. This may include:

1. Repeat PSA testing to confirm results
2. Digital rectal examination (DRE)
3. Prostate imaging, such as MRI
4. Prostate biopsy

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 testing, such as a prostate MRI, to better visualize the prostate and identify any suspicious areas. This information can then guide further decisions, including whether a biopsy is necessary.”

The Role of Advanced Diagnostic Techniques

In recent years, advanced diagnostic techniques have emerged to complement PSA testing and improve prostate cancer detection accuracy. These may include:

• Prostate Health Index (PHI)
• 4Kscore Test
• PCA3 Test
• ExoDx Prostate Test
• Multiparametric MRI

Your healthcare provider may recommend one or more of these tests based on your individual circumstances and PSA results.

The Future of PSA Testing: Emerging Technologies and Approaches

As medical science advances, new technologies and approaches are being developed to enhance prostate cancer screening and diagnosis. Some promising areas of research include:

Artificial Intelligence in PSA Interpretation

Researchers are exploring the use of artificial intelligence (AI) algorithms to improve the interpretation of PSA test results. These AI systems can analyze multiple factors, including PSA levels, age, family history, and other biomarkers, to provide more accurate risk assessments and reduce unnecessary biopsies.

Liquid Biopsies for Prostate Cancer Detection

Liquid biopsies, which analyze circulating tumor cells or cell-free DNA in the blood, are showing promise in detecting and monitoring prostate cancer. These non-invasive tests may complement or even replace traditional PSA testing in the future, offering more precise and personalized screening options.

Genetic Testing and Personalized Screening

Advancements in genetic testing are enabling more personalized approaches to prostate cancer screening. By identifying specific genetic markers associated with increased prostate cancer risk, healthcare providers can tailor screening recommendations and intervals to individual patients.

PSA Testing: Balancing Benefits and Potential Drawbacks

While PSA testing is a valuable tool in prostate cancer detection, it’s important to understand both its benefits and potential drawbacks. Discussing these factors with your healthcare provider can help you make an informed decision about PSA screening.

Benefits of PSA Testing

• Early detection of prostate cancer
• Monitoring treatment effectiveness for those with prostate cancer
• Non-invasive and relatively simple blood test
• Can lead to early intervention and improved outcomes

Potential Drawbacks

• False-positive results leading to unnecessary anxiety and additional testing
• Overdiagnosis and overtreatment of slow-growing, non-threatening cancers
• Potential complications from follow-up procedures, such as biopsies
• Psychological stress associated with screening and waiting for results

Your healthcare provider can help you weigh these factors based on your individual risk profile and personal preferences.

Lifestyle Factors for Prostate Health: Beyond PSA Testing

While regular PSA testing is important for prostate cancer screening, maintaining overall prostate health involves a comprehensive approach. Consider incorporating these lifestyle factors to support prostate health:

Dietary Considerations

A healthy diet can play a role in promoting prostate health. Consider including:

• Fruits and vegetables rich in antioxidants
• Whole grains and legumes
• Lean proteins, such as fish and poultry
• Healthy fats, like those found in nuts, avocados, and olive oil

Limiting red meat, processed foods, and excessive dairy intake may also be beneficial.

Regular Exercise

Engaging in regular physical activity can help maintain a healthy weight and potentially reduce the risk of prostate problems. Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week.

Stress Management

Chronic stress may negatively impact overall health, including prostate health. Incorporate stress-reduction techniques such as meditation, yoga, or deep breathing exercises into your daily routine.

Adequate Hydration

Staying well-hydrated supports overall urinary health and may help flush toxins from the body. Aim to drink plenty of water throughout the day.

The Role of Patient Education in Prostate Health

Empowering patients with knowledge about prostate health and PSA testing is crucial for promoting early detection and informed decision-making. Healthcare providers play a vital role in educating patients about:

• The importance of regular prostate health check-ups
• Risk factors for prostate cancer
• The pros and cons of PSA testing
• Interpreting PSA test results
• Available treatment options for prostate conditions

Patients should feel comfortable discussing their concerns and asking questions about prostate health with their healthcare providers.

Innovations in At-Home PSA Testing

Advancements in medical technology have led to the development of at-home PSA testing options, such as the imawareâ„¢ PSA test. These tests offer several advantages:

• Convenience of testing from home
• Potentially increased testing frequency for high-risk individuals
• Reduced anxiety associated with clinical settings
• Quick turnaround time for results

However, it’s important to note that at-home tests should not replace regular check-ups with a healthcare provider. Always discuss your at-home test results with a medical professional for proper interpretation and follow-up care.

The Importance of Ongoing Research in Prostate Cancer Detection

Continued research in prostate cancer detection and treatment is essential for improving patient outcomes. Current areas of focus include:

• Development of more specific biomarkers for prostate cancer
• Improved imaging techniques for more accurate diagnosis
• Personalized treatment approaches based on genetic profiling
• Novel therapies for advanced prostate cancer

Staying informed about the latest developments in prostate cancer research can help patients and healthcare providers make more informed decisions about screening and treatment options.

Supporting Prostate Cancer Awareness and Research

Raising awareness about prostate health and supporting research efforts is crucial for advancing prostate cancer detection and treatment. Consider getting involved by:

• Participating in prostate cancer awareness events
• Donating to reputable prostate cancer research organizations
• Sharing accurate information about prostate health with friends and family
• Volunteering for prostate cancer support groups or advocacy organizations

By working together, we can improve outcomes for those affected by prostate cancer and promote overall prostate health in our communities.

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.