Prostate Cancer

The PSA test

Patients discuss their experiences of PSA testing.

Most men we interviewed had PSA tests, either to help with diagnosis, or to monitor the impact of treatment. Most of the men we interviewed were tested when they consulted their GPs with urinary symptoms. However, two men were tested because they were taking part in treatment or screening trials and one man had a PSA test as part of a health scheme at work. Four men had routine tests when they were temporarily living overseas, and others had PSA tests as part of general blood tests when they consulted their doctors for a number of reasons, such as general fatigue, deep vein thrombosis or diabetes. One man was tested because he had a family history of prostate cancer.

The men we interviewed knew little about the prostate before they consulted their doctors, and very few men were given information about the PSA test, or the implications of an abnormal PSA result, before the test took place. However, some GPs did warn men that the PSA test was unreliable, and some men reported that their GPs were reluctant to conduct tests or investigate the cause of their symptoms. Perhaps this was partly because GPs are aware that the PSA test may give false positive results (results that suggest that cancer is present when it is not), and because of the known serious side effects of treatment.

Due to the uncertainties surrounding PSA testing and treatments for prostate cancer, it is very important that men who request a PSA test receive balanced information about the pros and cons to assist them in making an informed shared decision about being tested. This information should be provided by their GP or healthcare provider before the PSA test is carried out. The Prostate Cancer Risk Management Programme has written a Patient Information Sheet on PSA testing that should be given to all men considering a PSA test.

Most men seemed glad that they had had a PSA test, and many thought that all men over 50 should be tested (see 'Ideas on PSA screening and testing on demand'). Also, some men described how repeated tests could demonstrate the beneficial effects of treatment. One man was glad that regular PSA testing could monitor the situation, even though cancer had not been confirmed. However, two men were sorry that they had had PSA tests, and they regretted the anxiety caused by the abnormal PSA test result. One of these men did not have cancer diagnosed when he had a biopsy. However, he decided that even if cancer were diagnosed he would not wish to have surgery or other any other treatment because of the possible adverse side effects The other man, who was aged 74, decided that treatment would not necessarily prolong his life but might cause impotence or incontinence, which he feared. Having consulted two specialists he chose 'watchful waiting' rather than any other treatment.

For more information about PSA testing see the Healthtalk - PSA testing website.

 

Last reviewed July 2017.

Last updated January 2014.

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