PSA Testing

(Useful link: https://cks.nice.org.uk/prostate-cancer#!diagnosissub:5)

N.B. Patients should not ejaculate or do vigorous exercise for 48hours before a PSA and should not have it done within a month of a UTI

Who To offer PSA Testing to?

  • Any man over 50 who asks
  • Any man who has symptoms that could be related to prostate ca
    • back pain
    • bone pain
    • erectile dysfunction
    • haematuria
    • weight loss
  • Prostate on DRE that is large and irregular
  • PSA levels rising
  • Lower urinary tract symptoms

Ensure they’ve considered the risks and benefits

Benefits

  • Early detection
  • Early treatment

Risks

  • False reassurance
  • False Anxiety
  • Unnecessary investigations
  • Unnecessary treatments

Interpreting PSA results

Refer men if the PSA result is:

  • 2 or higher in 40-49yrs
  • 3 or higher in 50-59yrs
  • 4 or higher in 60-69yrs
  • 5 or higher in over 70yrs

(remember starting at 40 – 2,3,4,5!)

PSA Testing After Prostate Ca treatment

  • A six weeks
  • At Least Six Monthly for Two Years
  • At Least Annually For Life

Family history

Prostate Ca is

  • 2.1 – 2.4 x more common in those who’s father had it
  • 2.9-3.3 x if your brothers had it
  • 1.9 x higher if a second degree relative has had it.