Do elevated PSA levels mean you have prostate cancer? This is a very common question that we want to answer for you today.
Let’s talk about what high PSA levels mean as well as the impact that an elevated PSA result may have on patients, if not described properly.
Do elevated PSA levels mean you have prostate cancer?
No, elevated PSA levels do not mean you have prostate cancer however it does indicate that more screening is necessary to uncover the reasons why you have high PSA in the blood.
PSA stands for prostate specific antigen, traditionally PSA has been used as a biomarker for prostate cancer.
High PSA levels may indicate a number of other health conditions or environmental changes.
While high PSA levels don’t indicate that you have prostate cancer, it is recommended that patients attend a digital rectal exam (DRE) to rule out the causes of elevated PSA levels.
Here are four things your may not have known about PSA testing:
The test isn't cancer specific
The PSA molecule is produced by both cancerous and non-cancerous prostate cells. Despite its lack of cancer specificity, the test has become the cornerstone of prostate cancer diagnosis. Men need to be aware of the limitations of the test before doing the test, and they need to be prepared to attend follow up screening should their PSA levels be too high. At home PSA tests make the start of the screening process more convenient and cost effective for men, but following that primary screening, they may need to attend a physician for a digital rectal examination. (DRE)
PSA tests aren’t the only way to screen
New tests, such as 4K Score, are trying to improve the cancer detection specificity compared to standard PSA testing, however 4K score tests do not offer a definitive diagnosis but offer an indication of whether further testing is required, similarly to PSA testing.
MRIs for prostate cancer may be the next big thing
MRI of the prostate is noninvasive and essentially risk free. While not yet offered by all urologists, men concerned about prostate cancer should seek out physicians and centers that have this technology available.
You need to know your cancer
The LetsGetChecked PSA test helps you to get more insight on your PSA levels. Not all prostate cancers behave the same way. Many men who are diagnosed today have slow growing tumors which do not require treatment at all and are best simply observed.
To figure out how aggressive a specific tumor may be, urologists have long relied on the visual appearance of the cancer cells under the microscope but are now moving beyond this by using genetic assays. Two such tests, ProstaVysion and Oncotype DX, look at molecular markers in the individual tumors to predict how quickly the disease may spread.
The Emotional Impacts Of Elevated PSA: A Study
A study published in the American Journal of Men’s Health outlines a qualitative research strategy in which a small sample group of men’s comments, thoughts and feelings towards their PSA screening experience were documented.
The results largely exposed a lack of communication between practitioners and patients along with subsequent anxiety. Let’s explore how the study was carried out.
Participants who received an elevated PSA result were contacted following their screening to be interviewed for the study.
Participants were interviewed for a duration from 45 minutes to 120 minutes.
Participants were asked about their experience of PSA testing, with a focus on subjective feelings towards their results.
Three recurring themes emerged from the study:
All participants experienced uncertainty regarding what an elevated PSA was, as well as anxiety having learned that they had an elevated PSA.
Communication between practitioners either exacerbated the anxiety as described above or resolved it.
All participants attempted to enact coping mechanisms to deal with their perceived and anxiety by cause of their diagnoses.
Men who had elevated PSA levels, but not a prostate cancer diagnosis often went on to experience anxiety that stemmed from a lack of understanding around what it meant to have elevated PSA.
Those who described their care provider as patient-centered and approachable were more likely to cope with their cope with their initial anxiety better than those who felt that they couldn’t cope with their diagnosis.
Participants who experienced anxiety and uncertainty largely dealt with this by reaching out for healthcare advice, information-seeking, defensive cognitive strategies and self-monitoring their symptoms.
While this study highlights that PSA testing may heighten anxiety in those who take the test and don’t understand their results, it is important to note that elevated PSA is a bio-marker for a few conditions including prostate gland dysfunction, damage, ageing and obesity.
If results are explained clearly to patients, it is likely that the test will remain helpful to healthcare practitioners and patients. This study largely highlights the necessity of open and well executed communication between patients and healthcare practitioners to avoid anxiety, especially regarding health results they don’t fully understand.
As it stands, there is relative concern among the medical community that PSA testing may cause more alarm than good, however, it must be recognized that much of this worry comes from the screening practices that are used to establish the diagnosis.
It’s good to know that LetsGetChecked provide ongoing support and guidance at every step of the way of taking an at home PSA test. For those who wish to test their PSA levels, there is always someone on the other end of the phone to tell you more about what your results mean as well as the next steps you should be taking in the prostate cancer screening process.
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Written by Dr. Robert Mordkin | Edited by Hannah Kingston