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What should a man of 70 years PSA be?

3.5-4.5: Normal for a man 60-70 yrs. 4.5-5.5: Normal for a man 70-80 yrs.

texasurologyspecialists.com - PSA Testing | Texas Urology Specialists
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PSA Testing

PSA stands for prostate specific antigen. The prostate is the only place in the male body where this "hormone" is made. Women, therefore, do not have any PSA detectable in the blood. The prostate is a walnut-sized gland that sits below the bladder and surrounds the urethra. It contributes about 50 percent of the ejaculate volume, which helps the sperm survive for reproduction. PSA has a role itself in reproduction and also helps the sperm survive. The PSA is detectable in the blood through a special blood test. The prostate can "leak" PSA into the bloodstream that we can then measure. There are several instances where the PSA may be elevated. As men age, the prostate tends to get bigger and therefore the prostate of an 80-year-old man will usually secrete more PSA than a man in his forties. An infected prostate will tend to "leak" more PSA and may cause the level to be falsely elevated. In this situation the man is usually treated with antibiotics and a PSA is redrawn at a different date. Another situation where the PSA can be elevated is prostate cancer. A rectal examination should also be performed to identify any abnormalities. A prostate biopsy is often necessary to differentiate these three situations and rule out prostate cancer. The normal PSA value is usually stated to be less than 4.0. However, because of the fact that benign enlargement of the prostate gland tends to occur as men get older, an age-adjusted scale has been developed:

0-2.5: Normal for a man 40-50 yrs.

2.5-3.5: Normal for a man 50-60 yrs.

3.5-4.5: Normal for a man 60-70 yrs.

4.5-5.5: Normal for a man 70-80 yrs.

The PSA is not a perfect test but it can aid in detecting prostate cancer. Other factors that may falsely elevate the PSA value include a prostate biopsy, cystoscopy, vigorous rectal examination and ejaculating 48 hours before the sample is drawn. A new PSA test has been developed to better distinguish whether the PSA is elevated from prostate cancer or benign prostate disease and is called a free PSA. This test is based upon the fact that some of the PSA in the blood is bound to proteins, while some freely circulates in the blood. The lower the percentage of free to total PSA (<15 percent), the greater the worry that an individual has prostate cancer. Newer, more sensitive PSA tests are on the horizon and may help us in detecting prostate cancer more efficiently in the future. The American Cancer Society recommends that men over 50 years of age should have an annual rectal examination and PSA. Individuals of African-American descent or those with a family history of prostate cancer should begin screening at age 40.

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How painful is a biopsy of the prostate?

You will feel some pressure when the probe is inserted, but it is usually not painful. Usually between 6 – 12 (sometimes more) prostatic tissue samples are obtained and the entire procedure lasts about 10 minutes. A local anesthetic can be used to numb the area and reduce any pain.

Although the DRE and PSA tests are useful, they are not enough to make a clear diagnosis of prostate cancer. When results are abnormal or questionable, the doctor may prescribe a transrectal ultrasound and a biopsy. These examinations usually provide enough information for a precise diagnosis. Having to undergo prostate biopsies can be scary: fear of the intervention, the pain it can cause, the unknown … or knowing you have prostate cancer. But remember, if you have cancer, the sooner it is diagnosed, the greater your chances of a complete cure with treatment!

Why a biopsy

Abnormalities detected during a digital rectal exam and a high PSA level often lead to a prostate biopsy. This procedure consists of taking small tissue samples of your prostate in order for the pathologist to examine them under a microscope to determine if they are cancerous or not. That prostate biopsies are indicated does not mean that you necessarily have prostate cancer. Indeed, the analysis of microscopic specimens makes it possible to differentiate a benign hypertrophy from a cancer of the prostate. To this day, the actual diagnosis of prostate cancer can only be made with a prostate biopsy.

How

A prostate biopsy is usually performed during a transrectal ultrasound (TRUS biopsy). The images taken with the ultrasound help guide a fine needle to the areas selected for sampling. The spring-loaded needle is attached to the ultrasound probe and enters the prostate through the rectum. You will feel some pressure when the probe is inserted, but it is usually not painful. Usually between 6 – 12 (sometimes more) prostatic tissue samples are obtained and the entire procedure lasts about 10 minutes. A local anesthetic can be used to numb the area and reduce any pain.

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