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PSA testing is not merely a prostate cancer screening tool. After treatment, PSA monitoring is the primary method of measuring treatment success and detecting early signs of cancer recurrence.

In a business, due diligence means doing your homework, exploring all the options, and taking reasonable steps to protect yourself. When trying to make a decision about how to treat early-stage prostate cancer, taking time to conduct due diligence is absolutely vital for three reasons:

• No expert consensus exists about which treatment for early-stage prostate cancer is best (or when treatment is best postponed).

Understanding PSA

Ejaculation or vigorous bicycle riding can cause a small increase in your PSA level. Consider repeating your PSA test in two weeks, after you’ve avoided bicycle riding and intercourse for at least 48 hours. If your repeat PSA level returns to normal (less than four), this is excellent news. If your PSA test remains elevated, further evaluation is probably needed. Your options include:

• referral to a urologist (prostate specialist)

Understanding PSA

PSA levels can also go up for other reasons. For example, riding a bicycle can put pressure on the prostate and cause a temporary spike in your PSA level. The same is true for ejaculation during sex or masturbation. In general, these activities cause PSA levels to rise only a little, and the PSA should return to normal within several days.

Did you ride a bicycle, have sexual intercourse or ejaculate in the 48 hours before blood was drawn for your PSA test?

• Yes, I did.

Understanding PSA

Your PSA level is below 4.0 ng/ml. This is generally a reassuring result, and your risk of having prostate cancer is low.

However, your PSA level is slightly higher than expected for someone less than age 50. Speak with your doctor about the following options

• referral to a urologist (prostate specialist)
• repeat testing in 3-6 months to make sure that your PSA level is not rising

Understanding PSA

Next, we need to know your most recent PSA test result. Usually this is a number between 1.0 and 10.0 (PSA is measured in nanograms per milliliter, or ng/ml).

What was your most recent PSA level?

• Less than 1.0
• 1.0 to 3.99
• 4.0 to 6.49
• 6.5 to 9.99
• 10 or higher

Understanding PSA

Most doctors recommend waiting until age 50 to start PSA testing. That’s because prostate cancer is uncommon before this age. However, PSA levels are sometimes checked in men younger than age 50 because they have a risk factor for prostate cancer, such as having a close family member with the disease or being African-American (African American men are more likely than other men to develop prostate cancer and can develop an aggressive form of the disease at a young age).

Understanding PSA – Introduction

Welcome to this Decision Guide about PSA testing.

Prostate-specific antigen, or PSA, is a blood test used by many doctors to screen for prostate cancer. If you’ve had your PSA level checked, you may have been told that your results were “normal” or “abnormal.” However, some men would like to know more about what their PSA level means.

This tool provides more information about PSA levels, and what’s considered to be reassuring or worrisome for men of different ages.

Transrectal ultrasonography (TRUS) can create images of the prostate gland using sound waves. Doctors may recommend TRUS when they suspect prostate cancer based on an abnormal DRE or an elevated PSA.

Researchers are developing more screening tests for prostate cancer. Like the PSA test, they rely on biomarkers, such as antigens or proteins, which are elevated or may only be present in men who have prostate cancer. The hope is that these newer tests will better detect existing cancers (better sensitivity), and will not raise the alarm for cancer when it is not present (better specificity).

In this test, the doctor inserts a lubricated, gloved finger into the rectum and feels the surface of the prostate to determine whether it is swollen or has any lumps or abnormally textured areas (see Figure 1). This exam also helps doctors screen for diseases of the rectum, such as rectal cancer.

This imaging technique, which uses a powerful magnet and a computer to generate pictures of the body’s organs and tissues, can be used to diagnose prostate cancer or pinpoint the tumor’s location.

The National Cancer Institute discontinued the study after finding evidence that selenium and vitamin E supplements did not prevent prostate cancer.

The jury is still out on whether intermittent hormone therapy, which involves repeated cycles of hormone therapy followed by breaks in treatment, might help patients live longer than continuous hormone therapy. But Patrick Kirby’s story might help patients who are debating various options in hormone therapy.

Spotting blood in your semen can be worrisome, but it’s usually not cause for alarm.

Penile rehabilitation, which typically consists of oral or injected medications, alone or with other interventions, may help restore erectile function after treatment for prostate cancer. However, this therapy remains controversial.

Even if your doctor has given you a clean bill of health, beware: problems getting or keeping an erection firm enough for sexual intercourse may signal trouble, especially cardiovascular disease, down the road.

Three Harvard doctors talk about who needs to be treated for BPH, what medications should be prescribed, and what side effects you need to be aware of.

A look at treatment options and trade-offs

If you are like many of the 14 million men in the United States who have been diagnosed with benign prostatic hyperplasia (BPH), you’ve probably been taking the same medication, at the same dose, for years. If so, consider the experiences of two patients, both of whom were taking some type of medication for BPH. Their names have been changed, but all other details are accurate (see “Jack Muriel” and “Henry Banks”).

Penile implants, an option patients with erectile dysfunction probably hear little about, might offer a lasting and satisfying “cure.” Abraham Morgentaler, M.D., director of Men’s Health Boston, explains how.

Regular physical activity can help keep you — and your prostate — healthy

By now, we’ve all heard about the value of exercise in maintaining good health. Literally hundreds of studies conducted over more than half a century demonstrate that regular exercise pares down your risk of developing some deadly problems, including heart disease, stroke, and certain types of cancer (colorectal cancer, for example). It also eases the toll of chronic ailments like high blood pressure, diabetes, and arthritis.

Two registered dietitians from Harvard-affiliated hospitals tout the benefits of fruits, vegetables, and whole grains

“What can I eat to reduce my risk of developing prostate cancer?” That’s one of the most common questions physicians hear from men concerned about prostate health. Undoubtedly, many hope to hear their doctor rattle off a few foods guaranteed to shield them from disease. Although some foods have been linked with reduced risk of prostate cancer, the proof is lacking, at least for now.

How one man persisted for almost two years in an effort to remedy one of the most bothersome possible side effects of prostate cancer treatment, and what men facing therapeutic decisions can learn from his experience.