PSA (prostate specific antigen)

Having a PSA blood test either with a GP or specialist can provoke stress and anxiety. Men have a PSA either because they have lower urinary tract symptoms (LUTS), are thought to have an enlarged prostate due to benign prostatic hyperplasia (BPH), or have concerns about prostate cancer. 
PSA is a protein produced by the prostate that is released into the blood stream and is measured with a blood test. A normal PSA does not exclude prostate cancer and a raised PSA can be for a variety of reasons including a large prostate (BPH), an inflamed prostate (prostatitis), a urinary tract infection or prostate cancer.
A raised PSA, or a normal PSA with an abnormal feeling prostate needs investigating with an MRI scan and prostate biopsies under local anaesthetic. Small samples of the prostate can be sent for pathological analysis and can be taken with the aid of an ultrasound probe in the rectum. It is usual to take 12 core biopsies.
If these biopsies are inconclusive then a more detailed set of prostatic biopsies can be taken under a short general anaesthetic via the perineum (skin between base of scrotum and rectum). These are called template mapping biopsies. It is usual to take 24 biopsies and any abnormalities can be precisely mapped to a specific area of the prostate for treatment. The chance of missing a significant prostate cancer with template biopsies is very low. 
Subpages (1): Prostate cancer