How do I get a PSA test?
A colleague recently asked me how to go about getting a PSA test. As a prostate cancer survivor, I thought all guys know this. Then, I remembered that prior to my own diagnosis I had no idea what PSA was and, even more, I had never even considered that I was at risk for prostate cancer. So, here’s how to have a PSA test. . .
Please take your seats. It’s time to take the test!
Testing. It never seems to go away. And that “test” word always seems to get our attention and create just a little bit of anxiety, no matter how many tests we’ve taken in school and later on in life.
We can deal with most of our tests in our lives because we know what they are for and what the scores mean. This isn’t the case with most medical tests we take, however. We visit our doctor for our annual exam and he or she orders a battery of blood tests, most of which we have never heard of before.
One of those blood tests for men is called the PSA test, which stands for Prostate Specific Antigen.
So, just what is this PSA thing?
The acronym stands for prostate specific antigen. Without going into the science of the test, prostate specific antigen is a protein that is found in the blood and is used as a marker for prostate cancer.
There continues to be a bit of controversy within the medical community about the efficacy of the PSA test for predicting prostate cancer. However, the annual death toll from prostate cancer has steadily declined since the test’s introduction and widespread use beginning in the mid-1990s.
Is the PSA test like donating blood to the Red Cross?
Well, the PSA test does require giving blood, but the amount of blood needed for the test is nowhere near the pint we give when we donate to the Red Cross blood bank.
Getting a PSA test is pretty straight forward. The first method is to request your doctor to include it in the blood panel he or she orders during your annual physical. The nurse usually takes two small vials of blood for testing and within a day or two you have the results. This blood panel also is where your doctor reads your cholesterol and other values.
If you don’t have a family physician or if you doctor refuses to order a PSA test for you, you can simply “do it yourself.” There are a number of online testing services, such as BloodTestsatHome.com*, ranging in cost from $25 to approximately $50.
Once you sign up online, you will receive a testing kit that simply requires you to prick your finger and deposit two or three drops of blood on the enclosed sterile gauze pad and return it to the lab. Within a week you will have your PSA result.
Finally, you can simply call your local lab, such as LabCorp or Life Extension Foundation*, and schedule a blood draw and test directly.
Great. You have your result, but what does it mean?
This is the interesting part of the PSA test and is the basis for the ongoing angst within the medical community about the PSA test.
The PSA is reasonably accurate but, as with most tests, there are false positives, meaning some men who do not actually have prostate cancer are diagnosed with the disease, while others receive false negative reading, meaning they have prostate cancer that is not detected.
False positives sometimes result in unnecessary treatment and possible side effects, while men with false negatives may eventually wind up with advanced prostate cancer.
To further complicate the issue, there is no set of absolute PSA numbers that predict the presence or absence of prostate cancer. PSA values tend to rise in parallel with the increase in size of the prostate gland as men age, making an absolute value of little use.
Look for a rising trend – velocity of change
PSA velocity, or the change in PSA value over time, has been correlated with an increased probability of aggressive prostate cancer. A change in PSA value of approximately .75 over t2 months is an indicator of possible prostate cancer and should be carefully explored with a physician.
Summary
Prostate cancer is the most common male cancer in the America and is the number two cause of male cancer deaths. While 1 in 6 men will be diagnosed with prostate cancer during their life, only 2.5% of those men will have the aggressive form of the disease.
While these statistics are comfortingly low, more than one million men have died from prostate cancer since President Richard M. Nixon declared the “War on Cancer” in 1971. In 2010, more than 32,000 men perished from prostate cancer in America alone.
There are a number of easy ways to have a PSA test, and the earlier the cancer is detected, the more treatment options are available.
Next Steps
Men 35 and older should have an annual PSA test to establish a baseline value for what is normal for them. If you are 35 or older, just ask your doctor to include the PSA in the blood panel during your next annual exam. If this isn’t possible, consider using one of the online services or a local diagnostic lab.
You then to track the results in a simple matrix that will allow you to identify a rising value that would indicate the need for more diagnostics.
Women can play a key role in convincing the men in their lives to take this simple test, and men need to return the favor because breast cancer is the virtual mirror image of prostate cancer in terms of new cases and annual death rates.
Warm Regards, Robert
* I’m not endorsing either of these organizations, simply pointing out that they provide PSA testing services.
