Dr James Thompson is an experienced robotic, laparoscopic, endoscopic and open urological surgeon. He has sub-specialty training in (and passion for) the treatment of prostate, bladder and kidney cancer using the latest robotic surgery techniques and for high-impact cancer research that has the ability to immediately improve quality of life and cancer cure rates for the community.
PSA SCREENING
a guide for men and their gps
WHAT IS PSA?
Prostate Specific Antigen is a molecule produced by the prostate. Its function is to liquefy semen.
PSA levels in the blood are abnormally high in >95% of prostate cancers, especially large aggressive cancers.
Those rare cancers with normal PSA are detected by rectal examination (DRE).
WHO SHOULD BE OFFERED A PSA?
Aged between 50 to 74 years and in good health OR
Aged 45 to 50 with a family history of prostate cancer OR
A strong history of breast cancer in the family OR
A suspicious lump on rectal examination
What level of PSA is abnormal?
There is no exact ‘cut-off’ below which no one has cancer or above which all men have cancer
The likelihood of cancer goes up with the PSA level
For a PSA of 1, the likelihood of cancer is 1 in 1,000
For a PSA of 2.5, the likelihood of cancer is 1 in 100
For a PSA of 4, the likelihood of cancer is 1 in 4
For a PSA of 10, the likelihood of cancer is 1 in 2
For a PSA of 100, the likelihood is 100%
If PSA IS ABNORMAL, WHAT NEXT?
Do a DRE
Ensure PSA was not immediately after riding a bike, ejaculation, DRE, catheter insertion or other procedure
Exclude UTI / prostatitis, give antibiotics if symptoms
Repeat the PSA after 4 weeks
Add a Free / total PSA ratio
Calculate the PSA density and velocity
If Normal, when should spa be repeated?
If PSA < 1 at age 40, repeat at age 50
For 50 - 75 years, repeat every 2 years
If borderline, repeat at 4 weeks then at 6 months
