Prostate-specific antigen (PSA) screening can detect prostate cancer in men before they develop symptoms. But a PSA test can’t tell whether the prostate cancer is likely to grow faster or spread. And screening may cause some men to have treatment that they don’t need, which can have serious side effects, including sexual dysfunction and urinary incontinence.
A PSA level can increase for many reasons besides prostate cancer, such as infection, difficulty urinating, using certain herbal supplements or having an enlarged prostate (not caused by cancer). Your doctor will take a sample of blood from your arm with a needle and put it in a special tube or vial. The procedure doesn’t hurt, but you might feel a slight prick or sting.
Your health care provider will check the results from your PSA test in about 2 weeks. If the PSA level is high, your doctor will order a rectal exam and other tests to find out what’s causing it. You should avoid having sex or masturbating for 24 hours before the test, because these actions can increase PSA levels. Also, tell your health care provider about any medicines you’re taking. Some drugs can cause the test results to be incorrect.
If the test shows that you have prostate cancer, your doctor will want to do more tests to find out how serious it is and whether it’s likely to grow faster or spread. You’ll have the option of having a biopsy. A biopsy is a procedure that removes some cells from the prostate to look for signs of cancer. This can cause minor side effects, such as pain and a small amount of bleeding from where the needle went in.
After you have surgery or radiation, your health care provider will use the PSA test to monitor for a return of the prostate cancer. This is called a biochemical recurrence. Biochemical recurrences can happen months or years before the cancer causes symptoms again.
In a large study, researchers found that PSA testing reduces the number of prostate cancer deaths. But the harms outweigh the benefits in most men. For every three cancers prevented by PSA screening, 60 men will have their lives shortened by treatments for unneeded tumors and cell changes that would never have caused problems. This “overdiagnosis” occurs in about 3 out of 10 men screened with PSA. Memorial Sloan Kettering experts have created the screening guidelines that you see here to balance these pros and cons.
