Chris Stubbings Uro-oncology CNS What is PSA???? Chris Stubbings Uro-oncology CNS

PSA Prostate specific antigen PSA is a protein that is only produced by the prostate gland. It`s job is to keep the fluid that carries the sperm (semen) in a liquid form. All men have some PSA in their blood, and the PSA level can be affected by:

AGE PSA rises with age. The accepted normal PSA result is up to 2.5ng/ml for men in their 40`s Up to 6.5ng/ml in their 70`s

INFECTION A urine infection can cause the PSA to rise. A simple urine test can rule out an infection This should be done prior to having a PSA blood test

BPH(benign prostatic hyperplasia) BPH is a common condition that mainly affects men over age 50. Non cancerous enlargement of the prostate. Increase in size of prostate can cause the gland to produce more PSA.

PROSTATITIS Inflammation of prostate gland. Inflammation allows more PSA to move from prostate to the blood and causes PSA level to rise.

PROSTATE CANCER Prostate cancer may cause the PSA level in the blood to rise. However, some men with early prostate cancer may not have raised PSA.

VIGOROUS EXERCISE It is not clear whether exercise such as cycling affects the PSA level. You may be advised to avoid vigorous exercise 48 hrs before a PSA test.

EJACULATION Ejaculation in the 48 hrs before a PSA test may affect the results , especially in younger men.

Digital Rectal Examination There is disagreement over whether a DRE will affect the PSA result. Where possible the PSA test is done before the DRE.

RISKS OF PROSTATE CANCER In the UK approx 1 in 9 men are diagnosed with prostate cancer.(Macmillan cancer support 2012) USA have higher incidence, due to the fact in USA more men have PSA testing to detect prostate cancer. Researchers are trying to find out more about the causes of prostate cancer.

AGE Strongest risk factor Men under 50 have a very low risk, but the risk increases with age. Estimated 80% of men in their 80`s will have some degree of prostate cancer.

ETHNICITY Some ethnic groups have a gretaer risk of developing the disease Black African and black Caribbean men are more likely to develop prostate cancer than white men. Asian men have a lower risk

FAMILY HISTORY Men who have close relatives (eg; father, brother, grandfather or uncle) who have had prostate cancer are slightly more likely to develop it themselves. It is thought that if father or brother develop disease at age of 60 or under Also more than one man on same side of the family has had cancer of prostate. Research shows that a faulty gene (BRCA1) linked to breast cancer may also increase risk of prostate cancer.(Only small number prostate cancers are thought to due to this faulty gene (5-10%)

DIET Men from western countries such as UK and USA have a higher rate of cancer of prostate, than men form eastern countries such as China or Japan. Western diets tend to contain higher animal fat (including dairy) and lower fresh fruit and vegetables. Asian men tend to have ahigher intake of soy in their diet. Soy and soy products contain chemicals called phyto-oestrogens. Researchers believe these might reduce risk of prostate cancer. A high intake of calcium may increase the risk of developing prostate cancer. Research studies show tomatoes and tomato products (such as ketchup) may protect against prostate cancer. This may be due to the high levels of lycopene. References: Macmillan Cancer Support 2012 Prostate Cancer Charity 2012