How reliable is the PSA value?
As already described, the PSA level is not tumor-specific but only organ-specific. Every man with a prostate also has a measurable PSA level. In everyday clinical practice, the value is usually used as a follow-up and progression marker, and is therefore more likely to be used if a prostate carcinoma has already been detected or treated.
Since the value is so unspecific, it is less suitable as a screening parameter and should only be used in combination with anamnesis, physical examination and DRU. As a rough guide, the following values apply: < 4 ng/ml: Prostate cancer very unlikely 4-10 ng/ml: Grey area, no exact statement possible > 10 ng/ml: Probability of prostate cancer approx. 40% In the so-called grey area (4-10 ng/ml), the PSAQ should also be determined.
- <4 ng/ml: Prostate cancer very unlikely
- 4-10 ng/ml: grey area, no exact statement possible
- >10 ng/ml: Probability of prostate cancer approx. 40%.
Which diseases besides prostate cancer increase the PSA level?
In principle, all changes in the prostate can increase the PSA level, but it can also be normal for all changes. The value is therefore very unspecific and only gives an indication of a possible change in the prostate. In addition to prostate cancer, these include: benign prostate hyperplasia (BPH), prostatitis (inflammation of the prostate gland), prostate infarction and even excessive cycling. In general, any suspicious value should be clarified by a doctor.
- Benign Prostate Hyperplasia (BPH)
- Prostatitis (inflammation of the prostate gland)
- The prostate infarction
- And even excessive cycling
How is the prognosis of prostate cancer related to PSA levels?
In general, prostate cancer can only be curatively treated and thus cured if it remains confined to the organ. As soon as it spreads beyond the organ boundaries or even forms metastases, the probability of survival decreases rapidly. The level of the PSA value plays a rather minor role in estimating the prognosis and can never be the sole or absolute indicator.
Anyway, it is very difficult to estimate the individual prognosis because it depends on many factors. One of the most important parameters is the histological findings, which are evaluated with the Gleason score. Other parameters are mainly the patient’s age, previous illnesses and general health condition.
The factors are evaluated together using so-called nomograms and can provide an estimate of the prognosis. However, this should be left exclusively to the treating specialist. and prognosis in prostate cancer.
