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Prostate Exam – Do You Know What to Expect?

A prostate exam test or PSA screening test is a type of blood test that is primarily used to screen for prostate cancer. This prostate cancer screening test portrays the amount of prostate-specific antigen (PSA) in your blood. A high PSA level indicates the sign of prostate cancer that is most common in men after a certain age. But high PSA levels can also mean some other noncancerous prostate problems, such as infection or benign prostatic hyperplasia (BPH), a noncancerous enlargement of the prostate.

Prostate Exam

The prime aim of this test is to detect early prostate cancer in men.

Test Summary

Also known as Prostate Screening Test, Total PSA Test, Free PSA Test
Test Type Blood
Blood gas test includes Screen for prostate cancer and BPH                   
Preparation Avoid having sex or masturbating for 24 hours before your PSA test
Reporting Within 24 hrs
Test price The price of this test may vary from city to city and lab to lab
Also included in Health Insurance Plans
Related tests Biopsy, Rectal Exam


PSA is a protein formed by both cancerous and noncancerous tissue in the prostate (a tiny gland that presents below the bladder in males). PSA is found in semen that is also produced in the prostate. Small amounts of PSA ordinarily circulate in the blood. The PSA test measures the higher levels of PSA that may indicate the presence of prostate cancer.

Why is the PSA Test Recommended?

Prostate cancer is one of the leading forms of cancer found in men that may lead to death if not treated. Early detection will help you adopt the right treatment methods. Prostate cancer may raise the levels of PSA. However, several noncancerous conditions also can increase the PSA level. Along with the PSA test, your doctor may recommend a digital rectal exam to evaluate the early signs of prostate cancer.

When Do You Need to Go for the PSA Exam?

First, talk to your doctor about the advantages and disadvantages of prostate cancer screening before plunging into the test. After evaluating your conditions, the doctor will decide whether you should go for the test or not. The American Urological Association recommends,

  • Under 40: No screening
  • 40 to 54: No screening if you are at average risk. If you are a high-risk member, your doctor will decide.
  • 55 to 69: Screening if your doctor suggests
  • Over 70 or less than a 10-15 year life expectancy: No screening

During The Test Procedure

A nurse or lab technician will collect a blood sample from your vein (preferably in your arm) by inserting a small needle. The blood sample is then analyzed in the lab to measure your PSA level.

The PSA Test Normal Value

Though there is no normal PSA for any man at any given age, men with prostate cancer have a higher normal than normal level. In general:

If your PSA result is in the borderline range (4 to 10), the % free PSA will be helpful in discriminating between prostate cancer or benign prostatic hyperplasia (BPH).

A high % free PSA (above 20%) indicates BPH, while a %- free PSA less than 10% portrays a higher chance of having cancer. 

Variations of PSA Test

Variations of the PSA test may include

1. PSA Velocity

PSA velocity is the change in PSA levels over time. If you have an elevated PSA level, this may indicate that there is a presence of cancer or an aggressive form of cancer. But recent studies have shown a doubt on the value of PSA velocity in the evaluation of prostate cancer from a biopsy.

2. Percentage of Free PSA

PSA circulates in the blood in two forms (either attached to certain blood proteins or unattached (free). If you have a high PSA level but a low percentage of free PSA, this may indicate that you have prostate cancer.

3. PSA Density

 Prostate cancers usually produce more PSA per volume of tissue as compared to benign prostate conditions. PSA density measurements adjust PSA values for prostate volume.

Limitations of the PSA Test

  • Early findings may not help you to deal with cancer

The PSA screening is required for the early detection of the tumor. But this may not be useful if you have an aggressive tumor or if it spread to other body parts before you found it.

  • The results are not accurate

If you have a high level of PSA but you don’t have cancer, then the result will give you a lot of unnecessary stress and lead to medical procedures you don’t need. 


Will, I need to do anything to prepare for the PSA test?

You should stay away from having sex or masturbating for 24 hours before your PSA test, as releasing semen may elevate your PSA levels.

Is fasting necessary for a PSA test?

Fasting is not required for PSA testing, but if you need more accurate results, you should not eat or drink anything for 7-9 hrs. before the test.

How do I minimize PSA levels naturally?

1. Eat more tomatoes
2. Choose healthy protein sources
3. Take vitamin D
4. Drink green tea
5. Exercise
6. Reduce stress

How often should you check your prostate?

For most men, every two to three years is adequate. Based on the results of your first PSA test, your doctor will recommend how frequently you need screening.

Is PSA higher in the morning or afternoon?

The highest or nearly highest peaks of serum levels of PSA or PAP were observed in the afternoon as compared to the morning. 

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