Q:  What is the PSA test?

A:  The Prostate-Specific Antigen (PSA) test uses a blood sample to monitor the level of PSA being produced by the prostate. It is important to understand that the PSA test is not a prostate cancer test. Rather, when PSA levels are monitored over a period of years, prostate cancer experts can detect spikes or elevations in a man’s PSA levels.

Q:  What is the PSA Velocity?

A:  Your PSA Velocity is the rate at which your PSA levels change over a period of time. PSA mapping by a prostate cancer expert is the best way to determineif elevations are cause for concern. A PSA level of 4.0ng/ml is considered normal, while changes of more than 2.0ng/ml per year is an indicator of the potential presence of prostate cancer, infection, or enlargement – Benign Prostatic Hyperplasia (BPH).

Q:  When should I have a PSA test?

A:  Currently, the American Urological Association recommends that most men only need a PSA every 2 years, and that men between the ages of 55 and 69 should consider the pros and cons of PSA testing before making their own decision about a testing schedule.

Based on his experience with prostate cancer, Dr. Samadi strongly encourages men to commit to annual PSA screenings and to get a baseline test at age 40.

He believes all men over the age of 40 should have a PSA (prostate-specific antigen) blood test and digital rectal exam as part of their annual physical. For those with prostate cancer risk factors – a family history of the disease or African American men – screening should begin even earlier. Through monitoring PSA levels, men who are at risk for developing of the disease can be closely and easily monitored.

If an elevated PSA level is detected, a prostate biopsy can be done to confirm the presence of cancer.

For men who have not yet started their PSA screening, but are experiencing difficulties urinating, a constant urge to urinate, the feeling that you can’t fully empty your bladder, or blood in your urine:  please see your doctor immediately. These could be signs of BPH or prostate cancer. Never leave your health to chance.


Q:  Why is there so much controversy about the PSA test?

A:  Those who oppose routine PSA testing do so because they believe it leads to unnecessary prostate biopsies and/or treatment.

Dr. Samadi believes these concerns are based on two faulty equations:

  1. PSA Test + Biopsy = Infection
  2. PSA Test + Prostate Cancer Surgery = Incontinence and Impotence

Neither of these is definitively true. While there are potentially negative side effects to all medical procedures, there are also very practical ways to mitigate these issues. The answer is in the hands of the prostate cancer specialist.

Once your PSA level indicates the potential presence of prostate cancer, you should seek the opinion of more than one specialist. Choosing the right specialist is very important. Align with a doctor or surgeon who is affiliated with a hospital with an outstanding track record for treating and eradicating prostate cancer in their patients. Biopsy infection can be prevented with pre- and post-antibiotics and an adherence to recovery recommendations.

Regarding treatment, the majority of criticism seems to fall on the surgical removal of the prostate gland. Robotic prostatectomy surgery is a very successful option with very positive outcomes, if you choose the right surgeon. Robotics is a hot trend in hospitals now. More facilities are purchasing the equipment necessary for all types of robotic procedures; however, access to the technology does not ensure success.
Robotic prostate surgeons must perform thousands of procedures to achieve the expertise required to preserve sexual function and urinary continence. The benefits of the robot in the hands of an experienced surgeon are unmatched.