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Total Prostate-Specific Antigen (Total PSA)

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Total PSA is a prostate tissue-specific protein used as a tumor marker for prostate cancer screening, diagnosis, and monitoring. It is found in:

  • Normal prostate tissue
  • Benign prostatic hyperplasia (BPH)
  • Metastatic prostate cancer
  • Prostatic fluid and ejaculate plasma

PSA is not detected in other cancers or tissues.

  • Half-life: ~4 days
  • Forms in the blood:
    • Free PSA (about 10% of total PSA)
    • Bound PSA (complexed with antiproteases)
  • Normal age-related increase, but should not exceed 4 ng/mL
  • Mechanical irritation of the prostate can cause a temporary PSA increase
  • Monitoring disease progression, early detection of metastases, and evaluating treatment effectiveness in prostate cancer.
  • Assessing the condition of patients with benign prostatic hyperplasia (BPH).
  • Screening for prostate cancer in men over 50 years old.

  • Important Considerations

  • PSA levels can remain elevated for up to 3 weeks after:
    • Prostate biopsy
    • Prostatectomy
    • Prostate massage
  • To ensure accuracy, total and free PSA should be measured using the same method and from the same blood sample.
  • Prostate cancer (80% of cases)
  • Benign prostatic hyperplasia (BPH)
  • Prostatitis (inflammation and infection of the prostate)
  • Prostate ischemia or infarction
  • Ejaculation before the test
  • Surgical procedures, trauma, or prostate biopsy