By Enyeribe Ejiogu
Men, as would be expected, are very conscious of their genital organ, the very part of their anatomy, which a certain renowned female columnist loves to refer to as men’s staff of office. Some men who are endowed secretly boast about this vital organ popularly known as the ‘third leg.’ It is so important in marital relationship that not a few marriages have broken down on account of the inability of penis to perform its role at certain times in life.
This can happen when the prostate gland has a major problem. The prostate gland is part of the male reproductive system. It is located between the end of the bladder and the shaft of the penis. It surrounds the urethra just beneath the bladder. The urethra is a tube that runs from the end of the bladder and connects with the penis. It is through this tube that urine from the bladder is passed out when a person urinates. The major function of the prostate is to produce prostate fluid, which is one of the components of semen. The muscles of the prostate gland also help propel this seminal fluid into the urethra during ejaculation.
Due to some causative factors, the prostate can become enlarged, to the point that it can squeeze the urethra, narrowing its lumen and making the passage of urine difficult and painful.
Medical science has been able to discover a way for early detection of prostate problems. The specialized blood test is called prostate specific antigen (PSA) test. The PSA measures the level of a particular enzyme found in the blood produced which is produced exclusively by prostate cells. Normal levels of PSA in the blood are small amounts between 0-2.5 ng/ml. Levels of PSA greater than 2.5 ng/ml, can be caused by cancer or benign, non-cancerous conditions such as enlarged prostate (benign prostatic hyperplasia (BPH), prostate inflammation, infection, or trauma. An elevated level of PSA is cause for concern that requires the doctor to do further and more detailed evaluation.
Normal prostate cells and prostate cancer cells make PSA even if they are outside the prostate. That is why PSA monitoring is so important. Returning prostate cancer cells, either confined to the prostate or which have spread to the bone or lymph nodes, will cause the PSA to rise. PSA is important for diagnosis, treatment and follow-up as well as useful for comparing treatment results.
The PSA blood test was invented by Richard J. Ablin. The test has played a key role in early detection prostate health problems, and is widely used to detect signs of early-stage prostate cancer.
Does age affect PSA?
In a study done by Austrian researchers under the Tyrol PCa Early Detection Program, the scientists were able to determine the level of PSA in the blood that should indicate a point of concern, for men in different age ranges and thereby show the likelihood of the person suffering from prostate cancer. Based on their research findings, they created a simple guide to show the level of PSA in the blood that should make a person go to see the urologist.
How PSA is measured
PSA is measured by a simple blood test. The typical test for diagnosis and risk group determination is the “total PSA” which is simply a measure of all the PSA. Since the amount of PSA in the blood is very low, detection of it requires a very sensitive technology (monoclonal antibody technique).
Total PSA is the sum of the free and the bound forms. Most PSA binds to other proteins in the blood. The remaining unattached PSA is named “free” PSA. Men with a lower percentage of free PSA have a higher risk for prostate cancer. For example, a man whose total PSA is 6.0 ng/ml with a 10 percent free PSA has a higher likelihood of having prostate cancer than another patient whose total PSA also is 6.0 ng/ml but with 35 percent free PSA. Therefore a high free PSA percentage is good. Free PSA is not used to monitor results after treatment only to evaluate risk before diagnosis. The free PSA test is particularly helpful in situations where a biopsy is negative but the PSA is slightly high. If there is a low free PSA, another biopsy 6-12 months later is usually recommended. If it is high, then a longer wait is usually recommended.
The free PSA test is a road sign to help determine whether further work-up and follow-up is necessary. A high free PSA does not guarantee that a person is free of prostate cancer. In some cases, a biopsy of a nodule will turn up prostate cancer despite a low overall total PSA and a high level free PSA. The total PSA is what is measured with the standard PSA test. Prostate-specific antigen, or PSA, is a protein produced by cells of the prostate gland. The PSA test measures the level of PSA in a man’s blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter (ng/mL) of blood.
When should a man have a PSA test?
While some have definitive guidelines, others leave the decision up to men and their doctors. Organizations that do recommend PSA screening generally encourage the test in men between the ages of 40 and 70, and in men with an increased risk of prostate cancer.
How often do you need a prostate exam?
In general, it is recommended that men with an average risk of prostate cancer start being screened with a digital rectal exam and PSA blood levels at age 50. There is some evidence that African-American men should start being screened a decade earlier, at age 40.