Prostate cancer is the most common cancer affecting men in the UK, with one in eight men diagnosed each year. The risk is even higher for black men, with rates reaching one in four. As March marks Prostate Cancer Awareness Month, consultant urological surgeon Marc Laniado emphasizes the importance of proper preparation before undergoing prostate cancer screening, particularly PSA blood tests, to achieve reliable results.
Mr. Laniado explains, “The prostate is a walnut-sized gland located below the bladder, responsible for producing part of the seminal fluid. Prostate cancer occurs when prostate cells begin to grow uncontrollably. However, prostate cancer isn’t a single disease but rather a spectrum. Some forms grow so slowly they may never cause harm, while others can be aggressive and require immediate treatment. Early differentiation between these types is critical.”
A PSA (prostate-specific antigen) blood test is typically the first step in screening. It measures the level of PSA protein in the blood, offering a quick, inexpensive, and non-invasive screening method. Yet, PSA levels are not specific to cancer; infections, prostate enlargement, and other factors can elevate PSA. Additionally, some cancers may not raise PSA levels, meaning this test is a useful screening tool but not definitive on its own.
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To avoid misleading PSA results, Mr. Laniado highlights four key rules men should follow before their PSA test:
- Avoid strenuous exercise or activities like cycling prior to testing, as they can temporarily raise PSA levels.
- Do not engage in ejaculation for 24-48 hours beforehand, since it can affect PSA readings.
- Avoid any prostate stimulation that could increase PSA, such as a digital rectal exam (DRE), catheterization, or biopsy.
- Inform your doctor if you’re taking medications, especially 5-alpha reductase inhibitors like finasteride or dutasteride, which can halve PSA levels and mask elevated results.
Importantly, if you have recently undergone a prostate biopsy, DRE, or catheter insertion, PSA levels may be temporarily elevated. It is advisable to wait at least six weeks after these procedures before having the PSA test redone.
By following these guidelines, men can help ensure their PSA test results are as accurate as possible, aiding early detection and appropriate management of prostate cancer.