Search
Close
Making the decision to have a PSA test depends on a variety of factors. Here are some tips that can help you make a good decision.
Cancer screening tests — including the prostate-specific antigen (PSA) test to look for signs of prostate cancer — can be a good idea. Prostate cancer screening can help identify cancer early on, when treatment is most effective.
But it isn't perfect. Some men may find that the downsides of prostate cancer screening outweigh the potential benefits.
Ultimately, whether to have prostate cancer screening is something you should decide after discussing it with your doctor, considering your risk factors and weighing your personal preferences.
Here's information to help you prepare for a conversation with your doctor.
Prostate-specific antigen (PSA) is a protein produced by both cancerous (malignant) and noncancerous (benign) prostate tissue. A small amount of PSA normally enters the bloodstream.
Prostate cancer cells usually make more PSA than do benign cells, causing PSA levels in your blood to rise.
Besides the PSA number itself, your doctor will consider a number of other factors to evaluate your PSA scores:
PSA testing is sometimes combined with a digital rectal exam (DRE) to feel the prostate for abnormalities.
Knowing the risk factors for prostate cancer can help you determine if and when you want to begin prostate cancer screening. The main risk factors include:
There are a number of pros and cons to the PSA test.
Pros of PSA screeningCons of PSA screeningPSA screening may help you detect prostate cancer early.Some prostate cancers are slow growing and never spread beyond the prostate gland.Cancer is easier to treat and is more likely to be cured if it's diagnosed in the early stages of the disease.Not all prostate cancers need treatment. Treatment for prostate cancer may have risks and side effects, including urinary incontinence, erectile dysfunction or bowel dysfunction.PSA testing can be done with a simple, widely available blood test.PSA tests aren't foolproof. It's possible for your PSA levels to be elevated when cancer isn't present, and to not be elevated when cancer is present.For some men, knowing is better than not knowing. Having the test can provide you with a certain amount of reassurance — either that you probably don't have prostate cancer or that you do have it and can now have it treated.A diagnosis of prostate cancer can provoke anxiety and confusion. Concern that the cancer may not be life-threatening can make decision-making complicated.The number of deaths from prostate cancer has gone down since PSA testing became available.PSA testing has lowered deaths, but the number may not be substantial enough to justify the cost and possibility of harm to the person undergoing the testing.
Detecting certain types of prostate cancer early can be critical. Elevated PSA results may reveal prostate cancer that's likely to spread to other parts of your body (metastasize), or they may reveal a quick-growing cancer that's likely to cause other problems.
Early treatment can help catch the cancer before it becomes life-threatening or causes serious symptoms. In some cases, identifying cancer early means you will need less aggressive treatment — thus reducing your risk of certain side effects, such as erectile dysfunction and incontinence.
You may wonder how getting a test for prostate cancer could have a downside. After all, there's little risk involved in the test itself — it requires simply drawing blood for evaluation in a lab.
However, there are some potential downsides once the results are in. These include:
Most medical organizations encourage men in their 50s to discuss the pros and cons of prostate cancer screening with their doctors. The discussion should include a review of your risk factors and your preferences about screening.
You might consider starting the discussions sooner if you're black, have a family history of prostate cancer or have other risk factors.
If you choose to have prostate cancer screening, most organizations recommend stopping around age 70 or if you develop other serious medical conditions that limit your life expectancy.