What is the PSA value?
PSA is an abbreviation for “prostate specific antigen”. This protein is only produced by the prostate and makes the seminal fluid thinner.
The PSA test measures how much PSA is circulating in the blood. Experts have established an age-dependent PSA standard value, but this is only a guide. It is impossible to give a generally valid limit value for the PSA level in healthy men.
In general, however, the following applies: In prostate cancer (prostate carcinoma), the PSA values are often significantly above the reference values and continue to increase as the tumor grows.
What PSA values are normal?
The normal values for PSA depend primarily on age. The following table shows which PSA values are normal at which age:
|
Age |
PPE standard range |
|
up to 40 years |
< 1.4 µg/l |
|
up to 50 years |
< 2.0 µg/l |
|
up to 60 years |
< 3.1 µg/l |
|
up to 70 years |
< 4.1 µg/l |
|
over 70 years |
< 4.4 µg/l |
When is the PSA value too high?
The PSA level is often significantly elevated in prostate cancer (but not always!). In addition, there are also more harmless reasons such as a benign enlargement of the prostate (BPH, benign prostatic hyperplasia).
In addition, it cannot be ruled out that cycling can increase the PSA value. To be on the safe side, men should refrain from cycling in the 24 hours prior to the scheduled blood draw for PSA measurement.
An elevated PSA level does not necessarily mean that prostate cancer is present. Conversely, a normal (low) PSA level does not safely rule out prostate cancer. PSA measurement alone is therefore not suitable for diagnosing or ruling out prostate cancer beyond doubt.
PSA value for early detection of prostate cancer
The significance of the PSA value for the early detection of prostate cancer is unclear. Since the introduction of PSA measurement, prostate cancer is detected much more frequently and earlier. However, only a few of those affected would really suffer health problems from the tumor or even die from it. This is because in many cases prostate cancer grows very slowly and only triggers symptoms after years or decades.
Conclusion: So far, it is highly controversial among experts whether the PSA value for early detection of prostate cancer does more harm or good overall.
PSA measurement for monitoring the course of the disease
What is undisputed, however, is that measuring the PSA value after prostate cancer treatment is useful. For example, during surgery the entire prostate is removed along with the surrounding tissue. Within a few weeks, the PSA level in the blood then drops into an undetectable range (below 0.2 nanograms per milliliter of blood).
If a PSA is suddenly measured in the blood again in a follow-up examination, this may indicate a return of the cancer (recurrence): Cancer cells could spread again in the area of the surgical site or elsewhere in the body. PSA testing can therefore be used to detect and treat a recurrence at an early stage.
Early detection of prostate cancer: Further examinations
To detect the malignant tumor at an earlier stage, men are therefore often offered further examinations (at their own expense): an ultrasound examination via the rectum (rectal ultrasound) and the PSA test. As mentioned above, the significance of the PSA level in the early detection of prostate cancer is controversial. No recommendation valid for all men can be made here.
Cancer Aid therefore advises all men to seek advice from a doctor about the various examinations. In individual cases, the man and the doctor should then decide together whether the PSA value should also be determined as part of early prostate cancer detection.