PSA (Prostate Specific Antigen) is a type of enzyme and normally has a reproductive function. It is the enzyme that allows the sperm fluid to liquefy after ejaculation during intercourse. Determination of the PSA enzyme level is possible with a blood test. If the PSA test is high for the age of the patient, it is called PSA elevation.
In addition to the threshold value for PSA being >4 ng/ml, it should be decided according to the age of the patient. Values >40 ng/ml for 50-2.5 years old, >50 ng/ml for 60-3.5 years old, >60 ng/ml for 70-4.5 years old and 70 ng/ml for >5.5 years old are considered abnormal. Apart from these values, the probability of the occurrence of prostate cancer also varies according to PSA density (PSA/prostate volume), PSA increase rate (annual increase amount), free/total PSA ratio.
It is a prostate-specific enzyme, not a prostate cancer-specific enzyme. Therefore, PSA elevation may increase in benign enlargement of the prostate, infections, prostate cancer and some temporary reasons. Higher than normal PSA values can be detected during the 2-3 day half-life after long-term cycling, prostate massage, and sexual intercourse. In such cases, patients usually need to be tested for PSA again 1-2 weeks later.
After taking the necessary history of the patients with high PSA, a digital rectal examination is performed to have an idea about the consistency, size and presence of nodules of the prostate. After this examination, imaging such as ultrasonography and multiparametric prostate MR can be performed to investigate the size of the prostate and the presence of suspicious lesions.