PSA, normal range-
Ans is 'a' i.e., < 4 ng/ml Prostatic Ca is the most common malignant tumor in men over 65 yrs. of age.Symptoms of Bladder outlet obstruction and back pains (due to bony metastasis in the pelvis & lumbar vertebra) indicate towards prostate Ca.o Serum acid phosphatase is a tumor marker of prostate Ca.o But now serum acid phosphatase assay has been superseeded by PSA assay (Prostate specific antigen).Prostate specific antigeno It is a glycoprotein produced only in the prostatic cells (both benign & malignant). It facilitates liquefaction of semen,o It is neither sensitive nor specific for early prostate carcinoma (it is prostate specific and not prostate cancer specific), nevertheless it gives some help in making a diagnosis.* Normal serum level-less than 4 nghnl* 4-10ng/ml-this range is common for both BHP and Ca.* More than 10 ng/ml-approx 75% will have cancer.o Since PSA is not specific for Ca, PSA Velocity & PSA density are used to detect Prostate cancer.o PS.A velocity is the rate of change in PSA levels over time and is expressed most commonly as the PSA doubling time. For men with a PSA above 4, PSA velocity of more than .75 ng/ml year is suggestive of Ca. While for those with lower PSA levels, rates above 0.5 ngmLper year should be used to advise biopsy .o PSA density is calculated by dividing the serum PSA by the estimated prostate weight (measured by TRUS). It was developed to correct for the contribution of BPH to the total PSA level.Values < 0.10 are consistent with BPH.>0.15 suggest cancer
< 4 ng/mL
4-10 ng/mL
10-20 ng/mL
> 20 ng/mL
Prostate & Seminal Vesicles