The PSA Blood Test and Investigations for Prostate Cancer
Harley Street, London
What is Prostate Cancer?
Prostate cancer occurs when cells in the prostate gland grow uncontrollably. This gland, located just below the bladder, plays a role in producing healthy sperm. While slow-growing prostate cancers are common and may not affect your health, prostate cancer is the second most common cause of cancer-related deaths among men in the UK.
Risk Factors for Prostate Cancer
You may be at a higher risk of developing prostate cancer if you:
- Are aged 50 or older.
- Have a close relative (father or brother) with a history of prostate cancer.
- Are of black ethnic origin, which doubles the risk.
Symptoms of Prostate Cancer
Early-stage prostate cancers often do not present any symptoms. However, if you notice any changes in your urinary habits or have concerns about prostate health, consult Mr. Raison, your healthcare professional.
The PSA Test
The Prostate-Specific Antigen (PSA) test measures the level of PSA molecules in the blood. While all men have some PSA in their blood, a raised PSA level can indicate several conditions, including prostate cancer, urinary infections, an enlarged prostate, or recent activities such as vigorous exercise or ejaculation.
Should You Have a PSA Test?
Deciding to have a PSA test is a personal choice. Here are some points to consider:
Advantages:
- Early Detection: The PSA test can detect prostate cancer before symptoms appear.
- Identifying Fast-Growing Cancers: The test can help find aggressive cancers early when treatment is more effective.
Disadvantages:
- False Positives: A raised PSA level does not always mean you have prostate cancer. Many men with elevated PSA levels do not have cancer.
- False Negatives: The test can miss some cancers. About 1 in 7 men with a normal PSA level may have prostate cancer, and 1 in 50 might have a fast-growing cancer.
- Need for Biopsy: If your PSA level is raised, you may need a biopsy, which can cause side effects such as pain, infection, and bleeding.
- Overdiagnosis: You might be diagnosed with a slow-growing cancer that would not have caused problems. This could lead to unnecessary worry and treatment, which can have side effects affecting daily life, such as urinary, bowel, and erection issues.
Before deciding, discuss the potential benefits and risks with Mr. Raison. Your personal health history and preferences are important factors in making this decision.
Investigation Pathway for Raised PSA Levels
When a PSA (Prostate-Specific Antigen) test indicates raised levels, further investigation is needed to determine the underlying cause. A raised PSA level does not necessarily mean you have prostate cancer, as it can be caused by other factors such as infections or benign prostate enlargement. Here’s a step-by-step guide to the typical investigation pathway for raised PSA levels:
Consultation
- Discussion of Results: If your PSA level is raised, Mr. Raison will discuss what this means and the possible reasons behind it.
- Symptom Review: Mr. Raison will ask about any symptoms you might be experiencing, such as changes in urination or discomfort, as well as your medical history.
- Risk Assessment: Your age, family history, and ethnic background will be considered to assess your risk for prostate cancer.
Repeat PSA Test
- Confirmation: Sometimes, a repeat PSA test is necessary to confirm the initial result. This helps rule out temporary factors that might have affected the PSA level, such as recent exercise, ejaculation, or infection.
Specialist Diagnostic Tests
- Magnetic Resonance Imaging (MRI)
- Multiparametric MRI: An MRI scan of the prostate is typically the next step. This non-invasive imaging test provides detailed pictures of the prostate, helping to identify any abnormal areas that might need further investigation.
Biopsy
- Transperineal Prostate Biopsy: If the MRI shows areas of concern, Mr Raison may recommend a biopsy. During this procedure, small tissue samples from the prostate are taken with ultrasound guidance. The samples are analysed in a lab to check for cancerous cells.
Discussing Results and Next Steps
Results Review
- Discussion with Mr. Raison: Once the test results are available, you will discuss them with Mr. Raison or your specialist. They will explain what the findings mean and whether further action is needed.
Treatment Options
If Prostate Cancer is Diagnosed:
- Active Surveillance: For slow-growing cancers that are not causing symptoms, active surveillance with regular monitoring may be advised.
- Treatment Options: If treatment is necessary, options include surgery, radiotherapy, hormone therapy, and chemotherapy, depending on the cancer’s stage and aggressiveness.
If No Cancer is Found:
- Monitoring: Even if cancer is not detected, ongoing monitoring of PSA levels may be recommended to ensure any changes are caught early.
- Addressing Other Causes: If other conditions, such as benign prostatic hyperplasia (BPH) or infection, are identified, appropriate treatment will be offered.
Important Considerations
- Informed Decision: Throughout the process, you will have the opportunity to discuss the risks and benefits of each step with Mr. Raison. Making informed decisions about your care is crucial.
- Support Resources: Emotional and psychological support is available, and you are encouraged to reach out to support groups or counselling services if needed.
Mr Raison is available for private urology consultations, treatments, and surgical procedures at The London Clinic, Harley Street.