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What and where is the Prostate?

The prostate is a small gland associated with the male reproductive system. It is about the size of a walnut, and sits just below the bladder. In fact, the tube (urethra) that connects the bladder to the penis runs through the centre of the prostate.

What does PSA stand for and what is it?
PSA stands for Prostate Specific Antigen. It is a chemical secreted by the prostate gland, and is found in the blood stream.

What is the significance of a man’s PSA level?
The level of PSA in the blood stream is affected by the size and state of health of the prostate. The prostate gland naturally increases in size with age, so the PSA level naturally rises with age. However, if a man has prostate cancer then his PSA level is likely to be elevated above the normal level for his age.

What is the PSA Test?
The PSA Test measures the level of PSA in a man’s blood. The test involves giving a sample of blood, usually taken from the arm. The sample is then sent away for analysis.

What is the significance of the PSA Test?
The PSA Test is a simple, non-invasive, test available to indicate whether a man is likely to have prostate cancer. If the PSA level is elevated above the normal level for a healthy man of that age, then this indicates the possible presence of prostate cancer. For a normal healthy young man, the level would be less than 1. For an older man of say 60 - 65 a normal PSA level might be closer to 4.
 
How reliable is the PSA Test? 
It is important to realise that there are several other prostate conditions, beside prostate cancer, which can cause an elevated PSA. These conditions, some of which can be temporary, are benign, and so the PSA test for cancer can yield what are known as false positives.

It is this uncertainty that has made GPs cautious about sending patients for PSA tests. The NHS has advised GPs that if a man asks for a PSA test he must be counselled. He must be told of the uncertainty surrounding the test, and that an elevated result (above about 4) is not conclusive evidence of prostate cancer. There is concern about the psychological effect a positive indication could have on a patient. Click here for a copy of the NHS information leaflet given to men who ask their GPs for a PSA test. This further explains the PSA Test.

Our Recommendation
The Association recommends that men should understand the fallibility of the PSA Test. However, early detection of prostate cancer is vital to ensuring the best chances of an effective cure. Every man over the age of 45/50 has the right to ask for a PSA test, and even more so if prostate cancer is in the family. The Association’s advice is that if you decide to ask for a PSA test you should not be put off by your GP.

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