Prostate cancers tend to grow slowly. Some tumors never become a problem, but this is not always the case. One monitoring tool is a blood test for prostate-specific antigen, or PSA.

PSA is released into the bloodstream from cells in the prostate, a walnut-sized gland that makes seminal fluid for carrying sperm. Elevated PSA levels can mean cancer is pr esent. Ejaculation can temporarily increase PSA, so avoid it befor e any PSA test. A digital rectal exam is also used to check for prostate cancer.

Early-stage disease usually has no symptoms, but they can show up later. Symptoms include having to pee more often, especially at night, or straining to empty your bladder; blood in your urine or seminal fluid; new onset of erectile dysfunction; discomfort or pain when sitting (caused by an enlarged prostate); or, less commonly, pain or burning during urination. Other symptoms can occur if cancer has spread beyond the prostate gland.

Should you get screened if you have no symptoms? There’s no easy answer, because tumor growth is hard to predict. Discuss your risks with your doctor. Currently, Medicare provides coverage for an annual PSA test for all Medicare-eligible men age 50 and older. Many private insurers also cover PSA screening.

If Your PSA is Elevated

An elevated PSA reading does not necessarily mean cancer is present. Elevated PSA readings can also mean:

Prostatitis (inflammation of the prostate)

Benign prostatic hyperplasia (BPH, or enlargement of the prostate)

Urinary tract infection (UTI)

A prostate biopsy or prostate surgery can also cause elevated readings. Your doctor may recommend another PSA test to confirm the original finding, as well as continued monitoring.

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Robert Boissoneault Oncology Institute