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Home » Is this prostate cancer?
Ask the Doctor

Is this prostate cancer?

Dr. Wale Okediran
December 30, 2023
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I recently went for a Medical check-up and discovered that my Prostate Specific Antigen (PSA) was on the high side of the normal reading. Kindly let me know if I have Prostate Cancer. I am a 66-year old man

Teslim (by SMS)

 

Prostate-specific antigen (PSA) is a protein made by cells in the prostate gland (both normal cells and cancer cells). PSA is mostly found in semen, but a small amount is also found in blood.The PSA level in blood is measured in units called nanograms per milliliter (ng/mL). The chance of having prostate cancer goes up as the PSA level goes up, but there is no set cutoff point that can tell for sure if a man does or doesn’t have prostate cancer. Many doctors use a PSA cutoff point of 4 ng/mL or higher when deciding if a man might need further testing, while others might recommend it starting at a lower level, such as 2.5 or 3. Most men without prostate cancer have PSA levels under 4 ng/mL of blood. When prostate cancer develops, the PSA level often goes above 4. Still, a level below 4 is not a guarantee that a man doesn’t have cancer. About 15% of men with a PSA below 4 will have prostate cancer if a biopsy is done. Men with a PSA level between 4 and 10 (often called the “borderline range”) have about a 1 in 4 chance of having prostate cancer. If the PSA is more than 10, the chance of having prostate cancer is over 50%.One reason it’s hard to use a set cutoff point with the PSA test when looking for prostate cancer is that a number of factors other than cancer can also affect PSA levels. Some of the factors include; an enlarged Prostate, PSA levels normally go up slowly as you get older, even if you have no prostate abnormality, an infection or inflammation of the prostate gland, can raise PSA levels in addition, recent ejaculation can make the PSA go up for a short time. This is why some doctors suggest that men abstain from ejaculation for a day or two before testing. Similarly, certain drugs including herbal mixtures can lower PSA levels. If your PSA test result is in the borderline range (between 4 and 10), you will need to see your doctor for further tests and examinations. One of such examinations is a digital rectal exam (DRE), during which, the doctor inserts a gloved, lubricated finger into the rectum to feel for any bumps or hard areas on the prostate that might be cancer. The prostate is just in front of the rectum. Prostate cancers often begin in the back part of the gland, and can sometimes be felt during a rectal exam. This exam can be uncomfortable (especially for men who have hemorrhoids), but it usually isn’t painful and only takes a short time.

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