Prostate-Specific Antigen (PSA) is a protein produced by the prostate gland, a small gland in men located beneath the bladder. The PSA test is a common blood test used to assess prostate health. This article explores what PSA is, delves into what “normal” levels signify for men around 70 years old, discusses various factors that can influence PSA readings, and provides guidance on how to interpret these results.
What is PSA?
PSA is a protein primarily produced by the cells of the prostate gland. It functions mainly to liquefy semen after ejaculation, helping sperm move freely. While PSA is mostly found in semen, a small amount normally enters the bloodstream.
The PSA test measures the concentration of this protein in the blood, typically reported in nanograms per milliliter (ng/mL). This test serves as a screening tool used to monitor prostate health, particularly for prostate conditions like cancer. An elevated PSA level can suggest a prostate issue, but it does not definitively diagnose prostate cancer.
Understanding PSA Levels at Age 70
There is no single “normal” PSA number that applies to all men, especially as they age. PSA levels tend to naturally increase with age, even in the absence of prostate problems. This natural rise is partly due to the prostate gland typically growing larger over time, which can lead to more PSA leaking into the bloodstream.
For men in their 70s, general reference ranges suggest that PSA levels may be higher than for younger men. Some guidelines consider a PSA up to 5 ng/mL, or even up to 6.5 ng/mL, as potentially typical for men in this age group. A level above 4.0 ng/mL typically warrants further investigation, but these are guidelines, not absolute diagnostic cutoffs.
It is important to recognize that an elevated PSA level does not automatically mean prostate cancer is present. Many factors other than cancer can cause PSA levels to rise, and individual health history plays a significant role in interpreting results.
Factors That Influence PSA Readings
Several factors, besides prostate cancer, can cause PSA levels to increase or fluctuate, making interpretation complex. One common cause is Benign Prostatic Hyperplasia (BPH), an age-related condition where the prostate gland enlarges non-cancerously. As the prostate grows, it produces more PSA, which can lead to higher levels in the blood.
Prostatitis, an inflammation or infection of the prostate, can also temporarily elevate PSA levels significantly. Medical procedures, such as a prostate biopsy, cystoscopy, or even a digital rectal exam (DRE), can cause temporary increases in PSA.
Certain activities can also influence PSA readings. Ejaculation and vigorous exercise, especially cycling, can temporarily increase PSA levels. Additionally, some medications, such as finasteride and dutasteride used to treat BPH or hair loss, can lower PSA.
Interpreting Your PSA Result
A PSA test is a screening tool, not a definitive diagnostic test for prostate cancer. An elevated PSA level indicates a need for further investigation but does not confirm the presence of prostate cancer. Many men with elevated PSA levels do not have prostate cancer.
When an elevated PSA is detected, healthcare providers often recommend next steps, which may include a repeat PSA test to check for transient fluctuations. A digital rectal exam (DRE) is often performed alongside the PSA test as a complementary screening tool. If other indicators, such as a rapidly rising PSA, an abnormal DRE, or a very high PSA level (e.g., above 10 ng/mL), suggest a higher risk, a prostate biopsy might be considered.
Decisions regarding prostate cancer screening and follow-up are complex and highly personalized, especially for men in their 70s. It is important to discuss your PSA results with your doctor, considering your overall health, family history, and personal preferences. Shared decision-making ensures that any further testing or treatment aligns with your individual circumstances and values.