PSA is a protein produced by the prostate gland. Although most PSA is carried out of the body in semen, a very small amount escapes into the blood stream. The PSA test is done on blood. Since the amount of PSA in blood is normally minute, the PSA test requires a very sensitive method based on monoclonal antibody technology. PSA in blood can be by itself as free PSA or it can join with other substances in the blood as bound PSA. Total PSA is the sum of free and bound forms. This is what is measured as the standard PSA test.
The PSA value used most frequently as the highest normal level is 4 ng/mL (nanograms per milliliter). However, since the prostate gland generally increases in size and produces more PSA with increasing age, it is normal to have lower levels in young men and higher levels in older men. Age-specific PSA levels are as follows (age group, upper normal): (40 - 49, 2.5), (50 - 59, 3.5), (60 - 69, 4.5), (70 - 79, 6.5). The use of age-specific PSA ranges for the detection of prostate cancer is controversial. Not all studies have agreed that this is better than simply using a level of 4 ng/mL as the highest normal value.
The PSA test is used in several distinctly different ways with respect to detecting prostate cancer. It can be used in men who are not known to have the disease as a screening test. It can be used to gauge the aggressivity of prostate cancer. And it can be used in men with prostate cancer to monitoring their disease.
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