PSA (Prostate Specific Antigen) is a protein which circulates in the blood and is detectable by blood tests. It is produced almost exclusively in the prostate and enables physicians to draw a conclusion on the activity of the organ. Various diseases of the prostate can cause an increase in blood PSA levels (e.g. infections, prostate enlargement and prostate cancer).
Based on this knowledge, a PSA test is primarily used in the context of early detection of prostate cancer. Thus, an elevated PSA is not necessarily a sign of prostate cancer. And a normal value does not exclude prostate cancer.
Because a PSA value is not a reliable tumour marker, this value must be interpreted by an experienced medical specialist. Important relative variables include PSA progression (pre-values), the prostate size, bladder or prostate inflammation, and the age of the patient. Most cancers of the prostate can be detected in an early treatable stage by combining palpation and prostate biopsy.
The latter is important as initially untreated prostate cancer can lead to death within 10 years on average. However, this is a statistical value, which can deviate substantially from case to case. Any prostate cancer diagnosis should therefore be discussed in advance with the patients and only makes sense if therapeutic implications such as surgical removal or radiation are also considered. In the case of slightly elevated PSA values, the level of free PSA (not protein bound) in the blood can be determined. Depending on the result, this can either indicate a benign or malignant disease.
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