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What to do if your PSA test is abnormal | Peter Attia & Ted Schaeffer — Whalespan

Content›Video›What to do if your PSA test …

What to do if your PSA test is abnormal | Peter Attia & Ted Schaeffer

Peter Attia19m · 2023-10-15

Claims Made

43

Claims Supported

23

Support Rate

53%

Support rate

23 of 43 claims supported

23 supported20 partial / not

Claims from this content

37

✓Well SupportedPSA density is a predictor of prostate cancer diagnosis, aggressiveness, and patient outcome.✓Well SupportedFree PSA percentage, along with absolute PSA, PSA velocity, and PSA density, provides valuable information for assessing prostate cancer risk.✓Well SupportedWhen most of the PSA in the blood is bound with limited free PSA, it is a strong marker that cancer cells are leaking PSA into the bloodstream.✓Well SupportedIn men under 60, a PSA density greater than 0.1 or 0.12 may warrant a biopsy if the MRI shows no lesion.Well Supported

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✓

Advanced PSA-based testing provides more detailed prostate health information than a standard PSA test.

◐Partially SupportedA percentage of PSA produced by prostatic epithelial cells leaks into the bloodstream and is measured in a PSA blood test.

◐Partially SupportedTransient PSA rises can occur due to inflammation or other factors, necessitating rechecking PSA to establish a new baseline.

◐Partially SupportedWith existing technology, people do not need to die of colorectal cancer and men do not need to die of prostate cancer.

◐Partially SupportedSome labs can perform free PSA measurements as low as 2 ng/mL.

◐Partially SupportedPatients should monitor their health using advanced metrics like PSA velocity and PSA density to diagnose prostate cancer.

◐Partially SupportedBaseline PSA testing at age 40 can help understand lifetime risk for prostate cancer.

◐Partially SupportedProstate-specific antigen (PSA) is a protein produced by the prostate gland that aids in the liquefaction of semen.

◐Partially SupportedDeaths from prostate cancer have significantly decreased due to PSA screening.

✕Not SupportedOfficial US prostate cancer screening guidelines are too vague and do not provide specific recommendations for PSA testing.

◐Partially SupportedIndividuals should get their PSA tested at an early age to understand their baseline and track it over time.

◐Partially SupportedThe NCCN recommends prostate cancer screening for men aged 45 and older, including a baseline PSA test.

◐Partially SupportedProstate-Specific Antigen (PSA) testing should be performed annually on all males.

◐Partially SupportedThe ratio of free PSA to total PSA helps differentiate PSA leaked from cancer cells versus benign cells.

◐Partially SupportedIt is important to balance early detection of potential prostate issues with avoiding overreaction and overtreatment.

◐Partially SupportedTotal PSA measured in a blood test includes both bound and free PSA.

◐Partially SupportedThe prostate enlarges with age and metabolic syndrome, potentially increasing total PSA.

◐Partially SupportedChanges in PSA levels over time are critical for assessing prostate cancer risk.

◐Partially SupportedProstate cancer screening with PSA testing has reduced deaths by 20-25%.

◐Partially SupportedA 45-year-old man's median PSA is between 0.5 and 0.7.

◐Partially SupportedMeasuring prostate size, PSA, free PSA, and PSA density from a single blood measurement is powerful and cost-effective.

◐Partially SupportedBaseline PSA testing at age 40 was modeled to assess lifetime risk.

◐Partially SupportedMost PSA in the bloodstream is bound to other proteins, primarily sex alpha-kallikrein-3 or albumin.

◐Partially SupportedPercent free PSA provides a strong correlation with prostate size.

◐Partially SupportedAUA, ACS, and NCCN guidelines recommend discussing the risks and benefits of screening.

◐Partially SupportedPSA density can be obtained from an ultrasound.

◐Partially SupportedA rapid rise in PSA can indicate a need for further evaluation for potential prostate issues.

◐Partially SupportedPSA is present in very high concentrations in semen (estimated at 100,000 ng/mL) to facilitate fertilization.

◐Partially SupportedIt is unclear how many of the 35,000 men who died of prostate cancer last year could have been saved by earlier screening.

◐Partially SupportedAnnual PSA testing is considered intensive, while trials showing reduced prostate cancer deaths used testing every two to four years.

◐Partially SupportedAdvanced PSA tests like the 4K score or Prostate Health Index use mathematical equations to predict the probability of aggressive cancers.

◐Partially SupportedA PSA below 2 ng/mL indicates an extremely low probability of lethal prostate cancer.

◐Partially SupportedOther sibling molecules to PSA, such as human kallikrein 2 (hk2), can be measured in advanced PSA blood tests.