One of the most common markers for detecting prostate cancer is PSA (Prostate-Specific Antigen).

“However, there are many misconceptions and myths surrounding PSA and its role in prostate cancer diagnosis,” says Mr. Christos Papachristou, Urologist-Andrologist SurgeonHead of the Urology Department of LETO, who then explains what PSA is, its normal values, when and how it should be measured, as well as how to interpret its elevated values.

What is PSA?

PSA is a protein enzyme produced by the prostate that circulates in the blood. Its main function is to liquefy the semen, facilitating fertilization. PSA is used as a biomarker for prostate cancer, as elevated values ​​may indicate the presence of the disease.

PSA values ​​by age

Normal PSA values ​​vary by age:

40-49 years: 0-2.5 ng/mL
50-59 years: 0-3.5 ng/mL
60-69 years: 0-4.5 ng/mL
70 and above: 0-6.5 ng/mL

These values ​​are indicative and may vary depending on the laboratory and measurement technique.

Normal PSA (Prostate-Specific Antigen) values

Normal PSA values ​​are those that do not exceed the upper limits for the subject’s age. It is worth noting that low PSA values ​​do not exclude the existence of cancer, while high values ​​do not necessarily confirm the existence of the disease.

At what age should a man start measuring his PSA, when should he repeat it and until what age?

It is recommended that men start measuring PSA levels from the age of 50.
For men at increased risk (eg, family history of prostate cancer), measurement should begin at age 45.
Repeat measurement should be done every 1-2 years, depending on the PSA values ​​and the instructions of the urologist.
Usually, regular measurements continue until age 75, unless there are specific medical indications for continuation.

In what situations does PSA rise?

Elevated PSA values ​​do not necessarily indicate prostate cancer.
They can increase in various situations such as:

Benign prostatic hyperplasia (BPH)
Prostatitis (inflammation of the prostate gland)
UTIs
After medical procedures on the prostate (eg, biopsy)
Physical activity that puts pressure on the prostate (eg, cycling)
Ejaculation and intercourse
Finger examination
Constipation

How do you investigate whether an elevated PSA level indicates cancer?

If PSA values ​​are elevated, the urologist will proceed with further investigation, which may include:
Multiparametric MRI of the prostate (mpMRI): This imaging test provides detailed images of the prostate and helps identify suspicious areas.
Prostate biopsy: If mpMRI shows suspicious areas or if PSA levels continue to rise, a biopsy may be done to take tissue samples from the prostate and analyze them for cancer cells.

“In conclusion, PSA (Prostate-Specific Antigen) is a valuable tool in the diagnosis of prostate cancer, but must be used with caution and in conjunction with other diagnostic methods.

The correct information and guidance from the specialist urologist is essential for making the best medical decisions” concludes Mr. Papachristou.