Detection of Prostate Cancer
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In addition to the digital rectal exam (DRE), where a physician feels the back of the prostate with his fingers, the prostate specific antigen (PSA) blood test significantly increases the ability to detect cancers and identify any abnormalities early, even before they can be felt on the exam.
The PSA is a test of an enzyme produced by normal and cancerous prostate cells. Normally, a small amount of PSA is constantly released into the bloodstream. When the prostate is irritated or damaged, larger amounts of PSA can be detected by the blood test, suggesting an increased possibility of cancer.
The normal range of a healthy PSA levels is 0.0 or 4.0. Some PSA tests have the upper limit of normal as 2.5., depending on the type of test administered. Men with prostate cancer usually have PSA levels in the 10s or 20s, and sometimes as high as the hundreds or thousands, indicating that the cancer may have spread to the bones or lymph nodes. However, an elevated PSA level does not always indicate cancer. Causes can include inflammation or infection of the prostate, simple enlargement or BPH, prostate stones, a recent urinary procedure, a recent prostate biopsy, or prostate or bladder surgery. Because the test is organ-specific, non-urinary infections such as the flu will not affect the PSA level.
Most physicians recommend both the DRE prostate exam and the PSA test once a year after age fifty. For high-risk patients, it is recommended that they have three yearly ultrasounds in addition to a PSA test every six months.
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