I have to get up three or four times a night to urinate and I find it difficult to start and stop passing urine. My GP thinks I might have an enlarged prostate and has suggested a PSA test. Can you tell me what this test is and what it might reveal? I’m 61 years old.
Mr Sunjay Jain, Consultant Urologist, Spire Leeds Hospital
Urinary symptoms such as yours are commonly caused by prostate problems. Most often this is just enlargement of the prostate but they can be caused by prostate cancer.
PSA stands for prostate specific antigen. This substance is produced in the prostate and small amounts get into the blood and can be measured. In prostate cancer larger amounts of PSA usually get into the blood and hence the test can be used to try to detect cancer early.
The generally accepted normal PSA for a man of 61 is less than 4ng/ml. If higher there is a significant chance of prostate cancer (>25%) and your GP will refer you to a urologist to discuss further investigations including a prostate biopsy (samples taken from the prostate with a needle). Other causes for a high PSA include infection and benign enlargement.
Before having the test it is important to understand that prostate cancer is very common as men get older and may not cause any harm. Hence often even if cancer is diagnosed it does not need treatment unless it shows aggressive signs.
Much more information is available from The Prostate Cancer Charity (phone: 0800 0748383, www.prostate-cancer.org.uk) who produce an excellent free leaflet: ‘Understanding the PSA test: A guide for men concerned about prostate cancer’