All we need to know about prostate cancer and PSA testing

Written in association with: Professor Greg Shaw
Published:
Edited by: Conor Lynch

In this article below, highly respected consultant urologist, Professor Greg Shaw, delves into the topic of PSA testing, breaking down what factors lead to a raised PSA, and how this type of test can help in the diagnostic process of prostate cancer. 

What is a normal PSA level?

Prostate Specific Antigen (PSA) testing has become a routine procedure in the UK for men considered to be at risk of prostate cancer. Understanding what constitutes a normal PSA level is crucial for interpreting test results accurately.

 

PSA, an enzyme produced by the prostate gland, can be detected in small amounts in the blood. However, interpreting PSA levels requires context. Factors like urinary infections, recent trauma, or benign prostatic enlargement can influence PSA levels, making it necessary to consider these factors before drawing conclusions.

 

Traditionally, age-specific PSA cut-offs have been used to determine whether further investigation is necessary. However, this approach oversimplifies the assessment, as it doesn't account for individual differences in life expectancy, family history, ethnicity, or prostate size.

 

Benign prostatic enlargement is common as men age, and benign prostate tissue produces PSA. Therefore, PSA levels should be considered in the context of prostate size. PSA density, calculated by dividing serum PSA level by prostate volume, provides a more accurate indication of prostate cancer risk.

 

In cases of elevated PSA levels, further investigation typically involves a multi-parametric MRI scan. This imaging technique not only assesses prostate volume accurately but also identifies suspicious areas for biopsy, aiding in the diagnosis of prostate cancer.

 

There is no universal PSA cut-off for all men, except for extremely low levels (<1ng/mL at 60 years old). Risk assessment for prostate cancer depends on various factors, including age, medical history, and PSA level in conjunction with other health conditions.

 

When should I seek a specialist consultation?

If concerned about PSA levels or at higher risk due to family history or ethnicity, consulting a specialist urologist is essential. Specialist urologists possess the expertise to interpret PSA levels in context and recommend further investigations or treatment accordingly.

 

Why is it important to measure PSA levels?

Understanding PSA levels and their significance in prostate cancer diagnosis requires careful consideration of various factors. By seeking specialist consultation and utilising advanced imaging techniques, individuals can make informed decisions regarding further investigation and treatment options.

 

For personalised assessment and expert consultation on prostate cancer concerns, consider booking an appointment with a specialist urologist at the Prostate Centre. Expertise and guidance from specialists like Professor Greg Shaw can provide valuable insights into prostate health and cancer management.

 

If you’d like to find out more about your PSA level, you can book an appointment with Professor Greg Shaw today via his Top Doctors profile. 

By Professor Greg Shaw
Urology

Professor Greg Shaw is a highly-respected and globally-recognised consultant urological surgeon based in London who specialises in prostate cancer, in particular robotic surgery, prostatectomy alongside urinary tract infection and urinary problems. He practises at The Prostate Centre, near Harley Street, while his NHS base is University College London Hospitals NHS Foundation Trust.

Professor Shaw is highly qualified with a BSc, MBBS and MD from the University of London, as well as an MRCS, FRCS (Urol) from the Royal College of Surgeons of England. After developing an interest in prostate cancer whilst undertaking his MD, he began his specialist urologist training in North London where he was awarded his urology fellowship.

Following this, he completed a four year lectureship at The University of Cambridge where he worked in a world-class research team, generated important research findings and was awarded a fellowship in robotic surgery.

Professor Shaw has performed over 1,100 robotic radical prostatectomies to date and strives to evaluate and incorporate the best technical modifications to attain excellent results. He prides himself in his very low complication rate.

Furthermore, he has developed several research collaborations including an enhanced recovery program for radical prostatectomy at his NHS base, safely increasing the number of patients being discharged home the day after robotic prostate removal. He also has developed and presented a novel surgical technique called complete urethral preservation during robotic assisted radical prostatectomy (RARP) which gives many patients immediate urinary continence.

Professor Shaw, who is a spokesperson for The Orchid Cancer Appeal, is a Professor of Urology at University of College London where he is leading the NeuroSAFE PROOF study to evaluate the cost effectiveness of the NeuroSAFE procedure during radical prostatectomy and the C-PRO-META study to evaluate the prognostic utility of circulating tumour cells in men undergoing surgery for prostate cancer. He has been awarded prizes for lectures delivered at international and national conferences, and one research project he conducted led to significant media interest including a front page article in The Daily Telegraph alongside global press coverage.

Professor Shaw's reputation clinical research also extends to his work as lead for Urology for the National Institute for Health Research (NIHR) for North Thames, while he was also involved in staff training for the NHS Nightingale Hospital in London. Furthermore he is a research consultant for the Royal College of Surgeons of England and has been a Clinical Studies Group member for the National Cancer Research Institute (NCRI).

Professor Shaw has published over 85 PubMed-linked papers, authored several book chapters and various other peer-reviewed articles. Furthermore he's the Associate Editor for uro-oncology for the British Journal of Urology International Knowledge project, where the team has developed an online curriculum supporting urology trainees and established consultants in their continued professional development.

Professor Shaw is a member of various professional organisations including the British Association of Urological Surgeons (BAUS), the European Association of Urology (EAU) and the Royal College of Surgeons of England.

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