PSA (prostate specific antigen) is an enzyme secreted from prostate cells that helps liquefy the semen. It is an enzyme largely produced by the prostate, but it is also secreted in very small amounts by the pancreas and salivary glands. PSA enters the bloodstream as a result of the disruption of the integrity of prostate cells. Passage of PSA into the blood can be seen in both benign diseases and prostate cancer that disrupt the normal structure of the prostate.
Except for prostate cancer, elevation of PSA in the blood can be seen in many prostate-related events and diseases. Since the half-life of PSA in the blood is only 3 days, many of these increases may be temporary. Therefore, in case of a sudden increase in PSA in a healthy individual with normal previous PSA values, all of the following conditions should be evaluated:
Situations that cause PSA elevation:
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Urinary tract catheterization (catheterization)
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Cystoscopy (endoscopic evaluation of the urinary tract)
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Sudden urge to urinate
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Ejaculation (48 hours)
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Prostate massage and prostate examination (2- 3 days)
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Transrectal Ultrasonography (1 week)
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Prostatitis (4-6 weeks)
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Prostate Biopsy (6 weeks)
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Closed prostate surgery (6 weeks)
After the above-mentioned periods are completed, the patient's PSA should be re-evaluated and the next decision should be made according to the new PSA. In addition, finasteride and dutaseride, which are 5 alpha reductase enzyme inhibitors and drugs used in the treatment of BPH (benign prostatic hyperplasia), reduce blood PSA levels by 50-60% after 6 months of regular use. Therefore, PSA results should be multiplied by 2 to find out the real PSA levels of patients using the above-mentioned types of drugs.
Evaluation of PSA
The joint recommendation of the American Cancer Society and the European Urological Association recommends that men with a life expectancy of at least 10 years, or who have 2 or more first-degree relatives with prostate cancer, starting from the age of 50. For those diagnosed with cancer, starting from the age of 45, PERFORMING FINGER RECTAL EXAMINATION ONCE A YEAR and CHECKING BLOOD PSA LEVELS ONCE A YEAR
PSA upper threshold values according to age:
40 – 50 years: 2.5 ng/ml
50 – 60 years: 3.5 ng/ml
60 – 70 years: 4.5 ng/ml
Over 70 years: 6.5 ng/ml
As a result of the evaluation of the blood PSA level measured according to the above-mentioned threshold values and the examination findings that will guide the doctor after digital rectal examination, a follow-up decision can be made, as well as treatment for benign prostatic hyperplasia or prostate biopsy. decision may be made.
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