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Prostate Specific Antigen (PSA)

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Prostate specific antigen is a serine protease that is produced by certain cells in the prostate gland and serves to liquefy semen after ejaculation. It plays a role in the diagnosis, treatment and follow-up of patients with prostate cancer, but the efficacy as an effective screening tool is under evaluation and debate. The PSA level of 4.0ng/ml is considered the upper limit of normal, but this figure varies with age. And since the PSA is indicative of the size of the prostate, increasing PSA level may simply indicate enlarging prostate tissue size.

Measurement of PSA level is the most sensitive test for early detection of prostate cancer, it is elevated in about sixthly five percent of cases of prostate cancers. But, it is an imperfect tumor marker, because of a high incidence of false negatives and lack of specificity. While there may be elevated levels of PSA level in prostate cancer, it is not diagnostic of prostate cancer, because other conditions may cause elevated levels. Such conditions include: benign prostatic hyperplasia, prostatic infarction,  prostattis,  and conditions requiring prolonged catheterization. Levels are also higher in blacks. Combined use of seurum PSA levels and digital rectal examination allows detection of a significant percentage of prostate cancers while they are still localized.

In patients that have established prostate cancers, PSA measurements can be used to stage the disease, assess response to treatment and detect early relapse.  But the effectiveness of isolated PSA relapse is not known.

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