PSA test

Overview

The PSA test is a blood test that measures the level of prostate-specific antigen (PSA), a protein made by the prostate gland. It is often used to help detect prostate cancer or other prostate problems, but a high PSA does not always mean cancer.

Yes, the PSA test is one of the most common screening tests for prostate cancer in men, especially those over 50 or with risk factors.

The PSA test is used for men, particularly those aged 50 and older, men with a family history of prostate cancer, and men of African ancestry (who are at higher risk).

Symptoms

Common symptoms

• Frequent urination, especially at night
• Difficulty starting or stopping urination
• Weak or interrupted urine flow
• Blood in urine or semen
• Pelvic or lower back pain

Symptoms in children

• The PSA test is not used in children.

Symptoms in older adults

• Same as common symptoms – older men may also experience changes in bladder control or discomfort.

Causes

Main causes

• Prostate cancer (can raise PSA levels, but not always)
• Benign prostatic hyperplasia (BPH) – non-cancerous enlargement of the prostate
• Prostatitis – inflammation or infection of the prostate
• Recent ejaculation (can temporarily elevate PSA)
• Urinary tract infection or medical procedures like catheter insertion

Risk factors

• Age over 50
• Family history of prostate cancer (father, brother)
• African or Caribbean ancestry
• Obesity
• Certain genetic changes (e.g., BRCA mutations)

When to see a doctor

See a doctor urgently if:

• If you cannot urinate at all
• If you have severe pain in your pelvis or lower back
• If you notice large amounts of blood in your urine

Book a routine appointment if:

• If you are a man aged 50 or older, discuss PSA screening with your doctor
• If you are at higher risk (family history, African ancestry), consider starting at age 40-45
• If you have any urinary symptoms that bother you

Diagnosis

The PSA test is a simple blood test. A sample of blood is taken from a vein in your arm and sent to a laboratory to measure the PSA level.

Tests that may be done

• PSA blood test
• Digital rectal exam (DRE) – doctor feels the prostate through the rectum
• Repeat PSA test if the first result is borderline
• MRI scan of the prostate (if needed)
• Prostate biopsy (if PSA and other tests suggest cancer)

What to expect at your appointment

The blood draw takes just a few minutes. Results usually come back within a few days. Your doctor will discuss what the number means and whether any follow-up is needed. A single high PSA does not mean you have cancer.

Treatment

The PSA test itself is only a screening tool – it does not treat anything. If an abnormal result leads to a diagnosis of prostate cancer or another condition, treatment depends on the specific cause, your age, and your overall health.

Self-care at home

• For non-cancerous causes like prostatitis: rest, warm baths, and drinking plenty of water may help.
• For BPH: avoiding caffeine and alcohol late in the day can reduce nighttime urination.
• Follow your doctor’s advice on fluid intake and bladder habits.

Medical treatments

If cancer is found, options may include active surveillance (monitoring without immediate treatment), surgery to remove the prostate, radiation therapy, or hormone therapy. For BPH, medications can help relax the prostate or shrink it. For prostatitis, antibiotics if it is bacterial. Your doctor will explain the best approach for you.

When is surgery considered?

Surgery is usually considered for localized prostate cancer that is aggressive or high-risk, or for severe BPH when medications do not provide relief.

Living with this condition

If you have been diagnosed with a prostate condition after a PSA test, you may need regular check-ups, follow-up blood tests, or imaging. Keep a log of your urinary symptoms and report changes to your doctor.

Lifestyle tips

• Stay physically active – regular exercise can improve urinary symptoms and overall health.
• Maintain a healthy weight – obesity is linked to higher PSA levels and prostate problems.
• Limit alcohol and caffeine, especially in the evening.

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, and whole grains. Some studies suggest a Mediterranean diet (fish, olive oil, tomatoes) may be beneficial. Limit red and processed meats. Exercise at least 30 minutes most days.

Mental health and emotional wellbeing

Waiting for PSA results or dealing with a prostate diagnosis can cause anxiety and stress. It is normal to feel worried. Talk to your doctor, a counsellor, or a trusted friend. Do not let fear stop you from seeking care.

Prevention

There is no proven way to prevent prostate cancer entirely, but a healthy lifestyle (maintaining a healthy weight, eating well, exercising) may lower the risk of aggressive prostate cancer.

Vaccines

There is no vaccine for prostate cancer or for conditions that affect PSA levels.

Screening programmes

PSA screening is controversial – it can find cancers early but also leads to false positives and overdiagnosis. Talk to your doctor about your personal risk and whether screening is right for you.

Complications

If left untreated

• If elevated PSA is due to undiagnosed prostate cancer that is aggressive, the cancer may spread (metastasize) to bones or other organs.
• Untreated BPH can cause urinary retention, kidney damage, or bladder stones.
• Chronic prostatitis may lead to long-term pelvic pain or urinary problems.

Long-term outlook

The outlook for most prostate conditions is very good. Many prostate cancers grow slowly and never cause problems. When caught early, prostate cancer is highly treatable. Even if treatment is needed, modern therapies are effective. With BPH and prostatitis, symptoms can usually be managed well. Stay in regular contact with your healthcare team.

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