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While prostate cancer is the most common cancer in Jamaica, it gets much less attention than it should. As a whole, Jamaican men are more at risk of dying from prostate cancer than their North American counterparts for several reasons, like their ethnicity. And according to our consultant urologist, Dr Elon Thompson, Caribbean men are at risk of developing more aggressive prostate cancers.
Lack of screening is a big reason prostate cancer is a problem in Jamaica. “We are at risk,” says Dr Thompson. “Screening will save you the morbidity and mortality of prostate cancer.” Annual Prostate-Specific Antigen or PSA tests are the most reliable screening method for prostate cancer. These blood tests are the best way to catch prostate cancer early.
Why Regular PSA Testing is So Critical
PSA is a protein produced by both normal and cancerous cells in the prostate. A PSA test measures the level of PSA in your blood as nanograms of PSA per millilitre (ng/mL) of blood.
In general, the more elevated your PSA level is, the more likely it is that you have prostate cancer. Still, a high PSA level doesn’t mean cancer is present. Further investigation is needed. Further, a low PSA level doesn’t mean that you are cancer-free. Your doctor may still decide that a prostate exam is warranted.
Getting your PSA test done annually helps the doctor track your PSA levels, so even if the level is considered “low”, any increases can signal that more testing is required.
What are the different PSA levels, and what is a normal PSA result?
In the past, doctors believed that any number below 4ng/ml was considered to be a normal level. That is no longer the case. Instead, what is normal for one man may be abnormal for another.
In general, men in their 40s and 50s have PSA levels below 1ng/ml. Still, a PSA level above 1 or below 2.5ng/ml may not be a cause for alarm. As men get older, PSA levels naturally increase as the prostate grows in size. As such, men in their 60s will always have a higher PSA level than younger ones, even if they are cancer free.
This is why it is critical to test your PSA levels regularly, so your doctor can know whether it is increasing. In general:
If your PSA is below 4ng/ml: There is a 15% chance of prostate cancer being present if a biopsy is performed.
If your PSA level is equal to 4ng/ml to 10ng/ml: There is a 25% chance of prostate cancer if a biopsy is performed.
If your PSA level is over 10ng/ml: There is more than a 50% chance of prostate cancer being present when a biopsy is performed.
Acute Reasons for Increased PSA Levels
Urinary Tract Infections: UTIs may spike PSA levels. Symptoms include a burning sensation when peeing, difficulty emptying the bladder, abdominal pain, and fever or chills. Tell your doctor if you have these symptoms. Your doctor may order a urine test and prescribe antibiotics.
Prostate Inflammation: Prostatitis is a common, treatable condition. It is often the result of a bacterial infection and causes prostate swelling and inflammation. Symptoms are similar to those of a UTI.
Recent Ejaculation: If you have ejaculated within the 48 hours before the blood for your PSA test is taken, this can temporarily increase your PSA levels. It is, therefore, important to refrain from any sexual activity for at least 48 hours before your blood is drawn.
Vigorous Exercise: Vigorous exercise can also inflate your PSA levels. It is, therefore, critical to refrain from strenuous exercise in the days leading up to your blood being drawn for the test.
Injuries: Trauma to the groin or prostate can spike your PSA levels.
Lowering your PSA Levels
Certain lifestyle changes, like diet and exercise, can help to reduce your PSA levels (though they do not prevent prostate cancer). “These changes take time to effect significant change,” says Dr Thompson. However, he also explains that “the aim is not really to try to lower it, but just to be aware of what it is.”
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