The role of PSA in prostate cancer diagnosis and screening

Summary: Most tumor markers are specific biomolecules present in higher concentrations than normal reference values in the serum of patients with a certain type of cancer. These molecules are produced by the cancer itself or the patient's body, which results in a metabolic or immune response of healthy cells due to the presence of cancer cells in the patient. According to the chemical structure, tumor markers can be enzymes, specific proteins, glycoproteins, various antigens, hormones, specific receptors, etc. PSA is a specific glycoprotein by chemical structure and is secreted by the acini and ducts of the prostate gland. Healthy prostate cells secrete it in normal concentrations from 0 to 4 ng/ml, while cancerous prostate cells secrete it in much higher concentrations. The tumor marker PSA is tissue-specific, that is, it is specific only for prostate diseases when its concentration increases many times. The concentration of tumor markers is determined to precisely monitor the success of the applied therapy in conditions of an already established diagnosis of the disease. Certain elevated PSA values may indicate progression of prostate disease or recurrence, or an inadequate response to prescribed therapy, while decreased PSA values indicate successful treatment for the disease and an adequate response of the body to it. The prostate is an important part of the male reproductive system whose role is to produce prostatic secretion that participates in the production of sperm, by mixing it with seminal fluid from the testicles. Prostatic secretion has a nutritional and protective role for sperm on their way to the egg in the uterus, so it facilitates the movement of sperm, creates an ideal acidic environment for their survival and contains substances with nutritional and energy value such as immunoglobulins, prostaglandins, fructose, citric acid, various enzymes. The prostate is responsible for the production of the male sex hormone testosterone, or dihydroxytestosterone (DHT), which is converted into testosterone under the action of the enzyme 5-alpha-reductase in the prostate. The prostate surrounds the ureter, and therefore any disease of it such as prostate cancer causes obstruction, i.e., urinary retention. Prevention of the disease is timely care for the general health of a man. The level of concentration of total PSA was examined in healthy male patients aged 40-80 years with diagnosed prostate cancer. The level of total PSA was also monitored in the same patients treated with appropriate anticancer therapy (Flutamid), and the effectiveness of the prescribed therapy was determined. The results obtained showed that in the control group of patients, the levels of total PSA were within normal reference values, while in patients with diagnosed prostate cancer, the values of total PSA significantly increased. In patients treated with appropriate anticancer therapy with Flutamid, a decrease in the concentration levels of total PSA was recorded, which indicates a successfully administered therapy and an appropriate response of the organism to it.