What do PSA values ​​mean

PSA value

What is the PSA value?

PSA is an abbreviation for "prostate-specific antigen". This is a protein that is only produced by the prostate. It makes the seminal fluid thinner.

The PSA test measures how much PSA is circulating in the blood. Experts have set an age-related PSA standard value, which is only intended as a guide. It is impossible to give a general limit value for the PSA level in healthy men. In general, however, the following applies: In prostate cancer (prostate cancer), the PSA values ​​are often significantly higher than the reference values ​​mentioned here and continue to increase as the tumor grows.

Warning: an elevated PSA level does not necessarily mean that the person has prostate cancer. Conversely, prostate cancer cannot be ruled out with certainty, even with normal PSA levels.

An increased PSA value can also be caused, for example, by a benign enlargement of the prostate (BPH, benign prostatic hyperplasia), an inflammation of the urinary tract or prostate gland or a prostate infarction. In addition, PSA levels usually increase with age.

On the other hand, even a low (normal) PSA value is not reliable evidence that prostate cancer is not present. Measuring the PSA value alone is therefore not suitable for unequivocally diagnosing or ruling out prostate cancer.

PSA value for the early detection of prostate cancer

It has not yet been clarified what role the PSA value actually has in the early detection of prostate cancer. Since the introduction of PSA measurement, prostate cancer has been detected much more frequently and earlier. But only a few of the sick men would actually get health problems or even die from the discovered prostate cancer. In many cases, prostate cancer grows very slowly and would therefore only lead to symptoms after years or even decades (clinically silent / latent prostate cancer).

The diagnosis of prostate cancer, however, scares most of those affected and is therefore emotionally very stressful. In addition, many men undergo treatment after diagnosis, which is often associated with side effects such as urinary incontinence or impotence. If one considers that only a minority would have had problems with prostate cancer, it becomes clear that many men are unnecessarily confronted with the stressful diagnosis of prostate cancer and that treatment would often be unnecessary.

Conclusion: So far, it has been very controversial among experts whether the PSA value for the early detection of prostate cancer is more harmful or useful overall.

PSA measurement for progress control

However, it is undisputed that measuring the PSA value after prostate cancer treatment makes sense. For example, the entire prostate and the surrounding tissue are removed during the operation. Within a few weeks, the PSA level in the blood falls into an undetectable range (below 0.2 nanograms per milliliter of blood).

If a PSA is suddenly measured in the blood again in a follow-up examination, this can indicate a return of the cancer (relapse): Cancer cells could spread again in the area of ​​the operation area or in other parts of the body. A relapse can therefore be identified and treated at an early stage using the PSA test.