Prostate cancer is the second most common cause of cancer death, behind lung cancer, in men in Australia. It is also the second most diagnosed, behind skin cancer. As such, the early identification of prostate cancer in order to allow for treatment before it spreads can be of significant benefit to many Australian men.
The prostate specific antigen (PSA) blood test has been used as a screening test for prostate cancer for decades, usually in combination with a digital rectal examination. PSA is a protein produced by normal prostate cells and found mostly in the semen. It can also be produced by prostate cancer cells, leading to higher levels in the blood stream, although all men with a prostate will have some amount of PSA in their blood. PSA also increases with age, and thus older men can be expected to have a higher PSA., sometimes making what is ‘normal’ for each patient difficult to assess.
While prostate cancer may cause a high PSA, a high PSA is not always caused by prostate cancer. It is important to understand that there are several benign reasons for PSA levels to increase, and your high PSA level does not mean you have cancer.
Upon receiving an initial high PSA result, we recommend a second PSA test, timed one to three months after the initial test, and if not already performed, another blood test called a free PSA ratio. This is important as it allows you to qualify for an MRI scan of the prostate, which is the next step in investigating you for prostate cancer.
At your appointment, Dr Beattie will review your PSA results and arrange a prostate MRI and a subsequent prostate biopsy if required. He will ask about your family history of prostate cancer, as well as your history of prior PSA tests or difficulties passing urine, so it is helpful to have that information available at your appointment.