September is observed as the National Prostate Cancer Awareness Month in the US. Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. The American Cancer Society estimates that in 2015, about 220,800 new cases of prostate cancer will be diagnosed and about 27,540 men will die of this cancer type.
Prostate-specific antigen (PSA) measurements in serum by immunoassay are widely used in the screening, diagnosis, and monitoring of patients with prostate cancer. PSA is a protein produced by the prostate. All men will have a small amount of PSA in their blood, and this amount rises as they get older. In addition to cancer, a raised PSA level may indicate benign or non-cancerous problems with the prostate, including an enlarged prostate, inflammation or infection of the prostate, or urinary infection.
The PSA test is a test that measures the amount of prostate specific antigen (PSA) in semen or blood. In 1994, the FDA approved the use of the PSA test in conjunction with a digital rectal exam (DRE) to test asymptomatic men for prostate cancer. While most healthy men have levels under 4 nanograms per milliliter (ng/mL) of blood, a level below 4 does not guarantee the absence of cancer – about 15% of men with a PSA below 4 will test positive for prostate cancer on a biopsy.
Having a biopsy can cause discomfort and anxiety. Special types of PSA tests such as the percent-free PSA that help avoid the need for unnecessary biopsies. Free PSA is PSA that travels alone in the body. The percent-free PSA (fPSA) is the ratio of how much PSA circulates free compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not. Therefore, this test is recommended to determine whether a prostate biopsy is necessary if PSA results are in the borderline range (between 4 and 10).
The American Cancer Society recommends that men whose PSA level is less than 2.5ng/mL may only need to be retested every 2 years and screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.
Leading manufacturers such as Beckman Coulter offer quality free PSA reagents and free PSA calibrators. The Access® Hybritech p2PSA on the Access Immunoassay Systems is an FDA-approved automated test that combines the [-2]proPSA measurement with total PSA and free PSA measurements from the same blood sample in a mathematical formula to calculate a Prostate Health Index (phi) that measures a man’s possibility of having the cancer.
Risk factors for this cancer type include factors that cannot be changed such as aging, race/ethnicity, geography, gene changes and family history. However, studies show that following a healthy low-fat diet, maintaining a healthy weight, and exercising regularly can help reduce the overall risk of getting prostate cancer. National Prostate Cancer Awareness Month encourages men to adhere to such healthy practices that can help reduce the risk of this deadly cancer.