Hey everyone, Abby here with nursing.com. In this lesson we’ll talk about PSA, prostate specific antigen, its normal values and what might cause it to be increased or decreased in the conditions in which we should draw this lab. Let’s get started. 

Prostate specific antigen abbreviated PSA measures the amount of PSA in the bloodstream. This lab is used to diagnose and assess prostate health, its size and its functionality. The prostate is this gland that sits around here, right at the exit of the bladder, into the urethra and surrounds the urethra in males. Some clinical indications and times that this would be drawn are when the prostate is enlarged and prostate cancer is suspected. It’s also used to stage prostate cancer and evaluate the effectiveness of treatments. This is an enlarged or hypertrophic prostate. It just looks uncomfortable. Normal therapeutic values for males is below four nanograms per milliliter. Females not having a prostate gland are going to have less than 0.5 nanograms per milliliter. Collection takes place in a serum separator tube or a gold top. 

When lab values are increased, that means that there’s probably trouble with the prostate gland, right? So, it could be inflammation. It could be cancer. It could even be in the case of urinary retention, because the gland is so enlarged that it’s pinching off the urethra and the urine is retained in the bladder. Now, in benign prostatic hypertrophy or BPH, that’s also when that gland is majorly, majorly, enlarged. This is an interesting lab because it’s kind of close to my heart. I worked with veterans in the hospital on a post-surg floor and pretty much every single one of ’em had BPH,  and we would often see a PSA drawn to evaluate for prostate cancer. The lab will be decreased when treatment is effective. So, this could even be chemotherapy for those that have prostate cancer or with medications that treat BPH. It’s also going to be decreased in the case of long term use of NSAIDs and that’s due to the anti-inflammation that helps the gland be less inflamed.. Thiazides reduce the bioavailable testosterone and are associated with resulting in hypogonadism and so, they can also be linked to reducing PSA values. Statins are used to treat cholesterol and cholesterol plays a role in the synthesis of androgen. Androgen, one of the sex hormones, affects the size of the prostate gland. So, it’s also going to be completely relevant. Now, medications in the family of five alpha-reductase inhibitors like Finasteride, and Dutasteride also decrease PSA levels. Some of that can be a little bit problematic according to the literature in diagnosing prostate cancer. You’ll have to read more about that. 

Our linchpins in summary for this lesson are that the prostate specific antigen or the PSA helps to diagnose an assessment of prostate health. A normal value for males is below four nanograms per milliliter and females below 0.5. An increased value is going to tell us that the prostate gland has some type of disease or disorder going on with it. It could also be in the case of BPH where the gland has gotten so large. A decreased value indicates effective treatment and, from certain medications like we talked about with NSAIDs, as well as statins and the thiazides. Now, you’ve all done great on this lesson and this wraps it up. Remember, we love you guys and we want you to go out, be your best self today and as always, happy nursing!

References:

• https://www.uptodate.com/contents/measurement-of-prostate-specific-antigen?search=low%20PSA%20lab&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=2#H3
• https://ltd.aruplab.com/Tests/Pub/0080206
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2940393/
• https://www.renalandurologynews.com/home/news/statins-found-to-decrease-psa-levels/
• https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/tests.html
• https://www.fda.gov/drugs/information-drug-class/5-alpha-reductase-inhibitor-information#:~:text=5%2Dalpha%2Dreductase%20inhibitors%20are,dutasteride%20(marketed%20as%20Avodart)
• http://www.nursing.com