In my experience as a medical practitioner, I do not know of a biomarker that creates more stress in patients than the PSA test and it causes a great amount of anxiety and stress in men. Anytime a man gets the PSA test and sees a high number on there, they more than likely are connecting that number to death. It hits your subconscious mind on so many levels and I have seen patients start going down the rabbit hole with worry and anxiety around their test results.
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And I totally see where you are coming from and I want to do all I can to reduce your anxiety and stress around this test so I recently published an episode on the Dr. Geo Podcast about the PSA test and what you need to know about it.
Let’s get into it!
What is The PSA Test
The PSA test is primarily used to screen for prostate cancer. The test measures the amount of prostate-specific antigen (PSA), which is a protein produced by cancerous and noncancerous tissue in the prostate.
The test determines the levels of PSA that may indicate the presence of prostate cancer. There are other conditions that contribute to high levels of PSA such as enlarged prostate that can contribute to high levels of PSA. That’s why I believe the PSA test needs to be explained because there are so many factors that can contribute to high levels. When you are getting the PSA test, the number being high is not a sign of more production of PSA in your bloodstream. Rather it is an indication that you have PSA leaking into the bloodstream and I explain more about it in the podcast episode about how this happens.
The PSA Value in a Blood Test
As I mentioned at the beginning of this article, this test can create a heck of a lot of stress. And I see a lot. Patients come into my office and they see a slight increase in PSA and they start going nuts. The number is so much more than an indication of prostate cancer and it’s important that you make sense of this number for your own sanity.
The next time you go get tested, the range that is provided to you from your lab work is somewhere between 0 and 4. I see this a lot where a man will get a 4.1 or 4.2 and they immediately think they have prostate cancer. That is not true. PSA’s are age-dependent.
In addition, the rapid growth or rise in a PSA number in many instances is more valuable than an absolute number. For example, if a man comes into my office and has a PSA of two. Six months later, the same man comes back into my office and he has a PSA of four. Then three months after that, he has a six. That is a rapid rise in PSA and I would want to look further into that number and assess if it’s prostate cancer or something else.
Now there is the possibility that prostate cancer can happen with a low PSA but it’s a very small segment of patients. Generally, the number reveals more value in diagnosing what is going on via the PSA as opposed to being an absolute result of prostate cancer.
Should I Get A PSA Test?
There are two aspects of the PSA and its role. One is before diagnosis and the other afterward. There has been a lot of confusion over the last 10 years about the PSA’s value and there are some government agencies that have even proclaimed that you should not even take a PSA in an office visit because they say that they have no value in helping diagnosed prostate cancer.
And I couldn’t disagree more with this approach. The PSA test although imperfect is still a good measure and evaluator of prostate cancer. Prior to 1990, most people who went to the doctor’s office and had prostate cancer already had an aggressive form of prostate cancer around the 60% mark. Fast forward to 2004 and 2005, only 3-5% of people have advanced prostate cancer because of the PSA test.
The problem with PSA test is that it has been abused and misused. When the PSA rose, it prompted many urologists to do biopsies oftentimes unnecessarily. This caused a ton of overtreatment.
Here’s what I suggest. When you get a PSA test, it’s not about what the number is, it’s what you do with that number. When I see patients with maybe what I would determine a little high of number of PSA, I wouldn’t rush them to biopsy. I would need more information and see what else the number is telling me and the possibilities associated with that high number. I suggest that whatever your number is, you look at all your treatment options no matter what.
You can listen to the full episode on Apple, Spotify, or wherever you get your podcasts episode
Disclaimer: This article is for general information only, and we’re not forming a doctor-patient relationship. The use of the information and all links associated with this podcast is at the listener’s risk and is not to replace medical advice from a physician or a healthcare practic
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