This article was translated from the original Portuguese. Português
# Demystifying PSA: 10 Key Questions Answered by a Specialist
## Introduction
PSA, or Prostate-Specific Antigen, is one of the most discussed tests when it comes to men's health. Dr. Bruno Benigno, urologist and uro-oncologist at Hospital Alemão Oswaldo Cruz in São Paulo and director of Clínica Uro Onco, answers the most frequent questions on the subject in an informative video.
## Normal PSA Level at Age 60
For 60-year-old men, the normal PSA value can vary. The general rule is that every 10 grams of prostate corresponds to approximately 0.8 of PSA. However, this metric is not universal, and other factors, such as the digital rectal exam and free PSA, are also important for a complete assessment.
## PSA Thresholds
A value of 4 nanograms per ml is generally considered the upper limit of normal for PSA. Values above 10 are concerning, and above 20, very concerning. However, these numbers can vary depending on the size of the individual's prostate.
## Enlarged Prostate: Extremes and Averages
Prostate size can vary significantly. Dr. Benigno reports having seen prostates weighing up to 333 grams, although the average for men over 50 is between 40 and 90 grams.
## What to Avoid Before the Test
Activities such as ejaculation, cycling and digital rectal examination should be avoided for 48 hours before the test so as not to alter PSA results.
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Book via WhatsApp Prostate cancer guide## Annual PSA Increase
PSA may naturally increase at a rate of 0.75 per year in men aged 50 and over. A faster rise may be a warning sign for conditions such as prostate cancer.
## Effect of Tadalafil on the Prostate
Although tadalafil is commonly used to treat erectile dysfunction, it can also improve urination and even slightly reduce PSA levels.
## Physical Activity and PSA
Walking is allowed before the test, but more intense activities, such as running and cycling, should be avoided.
## Signs of an Abnormal Prostate
In addition to elevated PSA, a painful or abnormal digital rectal exam and ultrasound findings may indicate prostate problems.
## Medications That Affect PSA
Finasteride and dutasteride are medications that can reduce PSA levels by up to 50%. Other medications, such as those for blood pressure and diabetes, generally do not affect PSA.
## Prostate Size and Cancer Risk
There is no direct correlation between prostate size and cancer risk. Factors such as age and family history are more telling.
## Conclusion
Dr. Benigno stresses the importance of regular visits to the urologist for a complete evaluation, which may include PSA, a digital rectal exam and, in some cases, a biopsy. Prevention is crucial, especially for men over 50.
For more information, visit the Clínica Uro Onco website.
*By Dr. Bruno Benigno, CRM SP 126265
🔸contact: ☎(11) 2769-3929 📱(11) 99590-1506 | whatsapp: 📲 https://bit.ly/2HCRkgt 💻 https://www.clinicauroonco.com.br/ Appointments: http://bit.ly/2WMMiCI R. Borges Lagoa 1070, Cj 52 V. Mariana - São Paulo - SP Dr. Bruno Benigno CRM SP 126265 Urologist at H. Alemão Oswaldo Cruz Uro-oncology and Robotic Surgery Instagram: @dr_benigno
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Accurate diagnosis, an individualized plan and an integrated team — robotic surgery, medical oncology and rehabilitation in one place. In person in São Paulo or via telemedicine.
Book via WhatsApp Prostate cancer guide
Dr. Bruno Benigno
Urologist and uro-oncologic surgeon (CRM-SP 126.265 · RQE 60022). More than 1,500 robotic surgeries. Member of the AUA, EAU and SBU. Meet Dr. Bruno · In the Media
This content is educational and does not replace a medical consultation. Each case must be assessed individually, based on AUA, EAU and NCCN guidelines.
