Tracking your PSA: Be proactive

Experts at the University of Texas MD Anderson Cancer Center advise men to keep a record of their prostate specific antigen (PSA) test results to help determine if they are at increased risk for prostate cancer.

"Recent reports have debated the usefulness of the PSA test, but men should not write off this exam," says John W. Davis, MD, assistant professor in MD Anderson’s Department of Urology.

"It’s still an effective way to track trends in your prostate over time," he says. Doing this increases the chances that your doctor will find prostate cancer as early as possible, when it’s most successfully treated."

Most men age 50+ should get tested

The prostate specific antigen, or PSA, test is a simple blood test. It measures the amount of PSA in a man’s bloodstream. PSA is a protein produced by the cells of the prostate gland.

"Starting at age 40, all men should talk to their doctor about the PSA test," Davis says.

Recent guidelines by the American Cancer Society stress that men should talk to a doctor before getting tested. A doctor can explain the possible benefits and risks of prostate cancer screening and treatment. 

MD Anderson recommends that men age 50 and older, with no family history of prostate cancer, get a prostate cancer screening exam every year. African-American men and men with a family history of prostate cancer should begin annual screening exams at age 45. Both a digital rectal exam and a PSA blood test should be performed.

Tips for tracking your PSA levels

"If you decide to do the PSA test after talking to your doctor, start tracking your PSA levels as soon as you begin testing," Davis says.

He suggests the following tips when recording PSA test results:

• Note the testing standard used to find your PSA level each year. Knowing this standard helps doctors compare measurements from one year to the next.
• Ask your doctor for the actual PSA number. Don’t just record the results as normal or elevated.

"Lower PSA levels may suggest you have a lower risk for prostate cancer," Davis says. "But, a low number, or normal result, does not mean you will not get the disease. This is why tracking trends over time, even among normal results, is so important."

Monitor PSA trends

When monitoring trends in your PSA levels, Davis suggests looking for these warning signs:

• Doubled PSA score: Has your score doubled in a year?
• Velocity (or speed of increase over time): The amount of PSA in the blood is measured in nanograms per millilitre. A greater than 0.35 nanograms increase over time is linked to a higher risk for prostate cancer.
• High PSA score: Between 2.5 to 4 nanograms is considered high and may put you at increased risk.

Other factors increase risk

"Your doctor also should consider other factors that may increase your chances for developing prostate cancer," Davis says.

Those factors include:

• Race: African-Americans get prostate cancer twice as often as white men.
• Family history: Your risk is higher if your brother, son or father had prostate cancer.
• Age: As you get older, your risk increases.
• Abnormal digital rectal exam: An abnormal exam result increases your risk.

"Remember, not every man should get a PSA test," Davis says. "Your doctor can help you decide whether or not the PSA test is right for you as well as when to begin testing."

(Source: University of Texas MD Anderson Cancer Center)