Prostate specific antigen (PSA); free

CPT4 code

Name of the Procedure:

Prostate Specific Antigen (PSA); Free

Summary

The Prostate Specific Antigen (PSA) test measures the level of PSA in the blood. PSA is a substance produced by the prostate gland, and this test specifically measures the levels of "free" PSA, which is PSA that is not bound to proteins in the blood. Elevated PSA levels can indicate the presence of prostate cancer or other prostate conditions.

Purpose

The primary purpose of the free PSA test is to help diagnose and monitor prostate health, particularly in the context of prostate cancer. It can help differentiate between cancer and benign prostate conditions, such as benign prostatic hyperplasia (BPH) or prostatitis.

Indications

Elevated total PSA levels
Abnormal digital rectal exam (DRE)
Symptoms of prostate issues, such as difficulty urinating or pelvic pain
Family history of prostate cancer
Monitoring the progress or recurrence of prostate cancer after treatment

Preparation

Minimal preparation is required.
Patients should inform their doctor of any medications they are taking, as some drugs can affect PSA levels.
Typically, no fasting is necessary.
Avoid ejaculation for 24-48 hours before the test, as it can temporarily raise PSA levels.
Some may need to refrain from vigorous physical activities that affect the prostate, such as cycling.

Procedure Description

A blood sample is taken from a vein, usually in the arm.
The blood sample is then sent to a laboratory where it is analyzed to measure the amount of free PSA in the blood.
No anesthesia or sedation is required.
The procedure is quick and similar to other blood tests.

Duration

The procedure itself takes about 5-10 minutes for the blood draw.

Setting

The procedure is typically performed in an outpatient setting, such as a hospital lab, diagnostic center, or doctor's office.

Personnel

A phlebotomist or a nurse usually performs the blood draw.
A pathologist or a lab technician analyzes the blood sample.

Risks and Complications

Minor risks associated with blood draws, such as bruising, bleeding, or infection at the puncture site.
Rarely, patients may feel lightheaded or faint.

Benefits

Helps in the early detection of prostate cancer.
Can differentiate between prostate cancer and benign prostate conditions.
Assists in monitoring ongoing prostate health and the effectiveness of treatment.

Recovery

No specific recovery time is needed.
Patients can resume normal activities immediately after the blood draw.
Follow-up appointments may be scheduled to discuss the results and any necessary further testing.

Alternatives

Total PSA test: Measures all PSA in the blood (free and bound) but is less specific than free PSA.
Digital Rectal Exam (DRE): Physical exam to assess the prostate's condition.
MRI or Ultrasound: Imaging tests for a more detailed view of the prostate.
Biopsy: If cancer is strongly suspected, a tissue sample may be taken for analysis.

Patient Experience

Patients typically experience minimal discomfort during the blood draw.
Pain management is usually not necessary, though discomfort can be managed by applying pressure or ice to the puncture site if a bruise forms.
Receiving results can cause anxiety, but discussing them with a healthcare provider can help manage concerns and decide on a course of action.