Early Detection of Prostate Cancer

What is PSA and how is it connected to prostate cancer?

Prostate-specific antigen (PSA) is a protein produced within the prostate gland. PSA is mostly found in semen, but small amounts can also be found in the blood of healthy men. PSA levels depend on age and naturally go up as you age. There are many reasons why PSA levels fluctuate and higher levels may indicate the presence of prostate cancer or other prostate conditions.

Prostate cancer is typically a slow growing cancer that can be present for many years before causing symptoms. Prostate cancer is highly treatable if diagnosed in the early stages and a PSA test can be valuable in aiding early detection.

What is a prostate-specific antigen (PSA) test?

A prostate-specific antigen (PSA) test is a simple blood test that measures the amount of PSA protein in your blood. Measuring PSA levels can be an useful tool in diagnosing prostate cancer as well as monitoring the progress of the disease in someone who has already been diagnosed with prostate cancer.

Who should get tested?

If you are a man over the age of 50, it’s recommended that you speak with your doctor about your risk of developing prostate cancer and whether you should have a PSA test. Your healthcare provider may recommend a PSA test if you:

• are almost 50 years old• have a family history of prostate cancer • are of African ancestry• have symptoms of prostate cancer• have already been diagnosed with prostate cancer

and are being monitored

When is this test ordered?

A PSA test may be ordered by your healthcare provider to:

• help detect prostate cancer early even if you don’t have any signs or symptoms

• check for cancer if you are experiencing signs or symptoms of prostate cancer

• confirm a diagnosis when other tests suggest prostate cancer

• predict a prognosis (outcome) for prostate cancer• predict if cancer has spread outside the prostate• plan treatment for prostate cancer• monitor you if you are already being treated for

prostate cancer • determine if cancer treatments are working• determine if cancer has come back after treatment

Prostate-Specific Antigen (PSA) Test

The third leading cause of cancer death, when prostate cancer is detected early, it’s more likely to be successfully treated.

men in Canada will be diagnosed with prostate cancer in their lifetime.

How can I get tested?

Testing is completed by LifeLabs at a Patient Service Centre or via our mobile lab service (available in select cities) through a simple blood sample. You will require a completed test requisition from your healthcare provider.

Understanding your results

Test results will be provided directly to your healthcare provider for discussion with you. The report will indicate:

1. Total PSA level in the blood2. Free PSA level3. Ranges for PSA levels

PSA levels depend on your age. As you get older, your PSA level will naturally go up. If you have a high PSA level, your doctor will talk to you about your options. A higher than normal PSA level doesn’t always mean you have prostate cancer. High PSA levels can also indicate:

• an enlarged prostate due to benign prostatic hyperplasia

• an inflamed or infected prostate (called prostatitis)• a urinary tract infection

It’s important for you to discuss your PSA level results with your doctor. Your doctor will help you determine your risk of prostate cancer in relation to your age, family history and other personal information.

How is the test performed?

Blood sample

How much does it cost?

The price of this test varies by province. The test may be covered by your private insurance or provincial health plan under some circumstances. Talk to your doctor about your options.

When will I get my results?

Results are available to your healthcare provider within 2 weeks.

Sources

• Statistics Canada: “Prostate cancer trends in Canada, 1995 to 2012”

• Prostate Cancer Canada

• Canadian Cancer Society

Requisition is valid for one year from the date of issue.

Patient Surname (from CareCard) First Initial(s) Sex

Bill to: MSP ICBC WorkSafeBC Patient OtherF M

Date of Birth

I.D. NumberPatient Address City, Province Patient Telephone NumberPostal Code

Ordering Physician, Address, MSP Practitioner Number

C0 Number

Date/Time/Name of Medication

Date/Time of Collection

Physician Signature

Copy to: Address,MSP Practitioner Number

Chart Number

Locum for:

DAY MONTH YEAR

INITIAL/DATE

Phlebotomist Data Entry

HEMATOLOGY

Diagnosis and indications for guideline protocol and special tests

PHN

Fasting

hours prior to test

Phone Fax

Physician

MSC #

D2400 (01/18)

CHEMISTRY

Room # (LTC use only)

URINE TESTS

Pregnant

For tests indicated with a shaded tick box , consult provincial guidelines and protocols (www.BCGuidelines.ca)

PT-INR

HFE – Hemochromatosis (check ONE box only)

Sibling/parent is C282Y/C282Y homozygote (DNA testing)

COMPLETE and ACCURATE information is required in all shaded areas.

Telephone Requisition Received By:

HEPATITIS SEROLOGY

The personal information collected on this form and any medical data subsequently developed will be used and disclosed only as permitted or required by the Personal Information Protection Act (and related acts and regulations) of British Columbia. LifeLabs privacy policy is available at www.lifelabs.com. Use of this form implies consent for the use of

Glucose - fasting (see reverse for patient instructions)GTT - gestational diabetes screen (50 g load, 1 hour post-load)GTT hour test)Hemoglobin A1cAlbumin/creatinine ratio (ACR) - Urine

Urine culture - list current antibiotics:

Macroscopic → microscopic if dipstick positiveMacroscopic → urine culture if pyuria or nitrite presentMacroscopic (dipstick) Microscopic

Special case (if ordered together)

LIPIDS✔ One box only. For other lipid investigations, please

order under Other Tests section and provide diagnosis.Baseline cardiovascular risk assessment or follow-up

Total, HDL, non-HDL & LDL Cholesterol, Triglycerides, fasting)Follow-up of treated hypercholesterolemia (Total, HDL & non-HDL Cholesterol, fasting not required)Follow-up of treated hypercholesterolemia (ApoB only, fasting not required)

THYROID FUNCTION✔ One box only. For other thyroid investigations, please

order under Other Tests section and provide diagnosis.Monitor thyroid replacement therapy (TSH Only)Suspected Hypothyroidism

OTHER CHEMISTRY TESTSSodium Creatinine/eGFRPotassium CalciumAlbumin Creatine kinase (CK)Alk phos PSA - Known or suspected prostateALT cancer (MSP billable)Bilirubin PSA screening (self-pay)GGT Pregnancy TestT. Protein Serum Urine

VAGINITISInitial (smear for BV & yeast only)Chronic/recurrent (smear, culture, trichomonas)Trichomonas testing

GROUP B STREP SCREEN (Pregnancy only)Vagino-anorectal swab Penicillin allergy

ROUTINE CULTURE

List current antibiotics: __________________________ Throat Sputum Blood

Wound Site: _____________________________DeepWound Site: _____________________________

Other:________________________________________

CHLAMYDIA (CT) & GONORRHEA (GC)CT & GC TestingSource/site: Urethra Cervix UrineGC culture: Throat Rectal

Other: ___________________________

STOOL SPECIMENSHistory of bloody stools? Yes

Stool cultureStool ova & parasite examStool ova & parasite (high risk, 2 samples)

DERMATOPHYTESDermatophyte culture KOH prep (direct exam)Specimen: Skin Nail Hair

Site: _________________________________________

Date

MYCOLOGYYeast Fungus Site: ________________

HIV SEROLOGYHIV Serology(patient has legal right to choose not to have their name and address reported to public health – non-nominal reporting)

Non-nominal reporting

Laboratory RequisitionThis requisition form, when completed, constitutes a referral to LifeLabs laboratory physicians. It is for

the use of authorized health care providers only.

THIS AREA IS FOR LAB USE

On Warfarin?

Standing Order requests - expiry and frequency must be indicated

✔ One box only. For other Hepatitis Markers, please order under Other Tests section.

Hepatitis A (anti-HAV lgM)Hepatitis B (HBsAg, plus anti-HBc if required)Hepatitis C (anti-HCV)

Hepatitis B (HBsAg, anti-HBc, anti-HBs)Hepatitis C (anti-HCV)

Investigation of hepatitis immune statusHepatitis A (anti-HAV, total)Hepatitis B (anti-HBs)Hepatitis marker(s) HBsAg

Yes No

MICROBIOLOGYLABEL ALL SPECIMENS WITH PATIENT’S FIRST AND LAST NAME, DOB AND/OR PHN & SITE

ECG

OTHER TESTSFecal Occult Blood (Age 50-74 asymptomatic q2y)Copy to Colon Screening Program.

Fecal Occult Blood (other indications)

41597

LifeLabs Locations Hours of operation are subject to change.

For current hours and locations visit our website at www.lifelabs.com

You will be asked to present your Care Card/BC Services Card at each visit.For tests not covered by MSP, payment can be made by VISA, MasterCard and Debit.Test Results for clinicians: 1-800-431-7206. Patients can register to receive test results at www.myehealth.ca

Patient Service Centres Hours (Monday to Friday) Fax

PATIENT INSTRUCTIONS: (unless otherwise indicated by your physician)Fasting Required: Do not eat or drink (except water) for 8-12 hoursbefore the following tests:

• GLUCOSE - fasting• GTT-gestational diabetes confirmation and GTT - non pregnant• LIPIDS/CHOLESTEROL - if indicated

Note: Chewing gum and brushing teeth during the fasting period isacceptable.Fasting is preferred, but not required for the following tests:

• Homocysteine, Iron/TransferrinH. Pylori: Do not eat, drink (except water), or smoke for 4 hours

before the test. Do not drink any fluid for the last hour of fasting.AM Cortisol and Testosterone: Collect sample within 3 hours of waking

Patient Instructions are also available on our website www.lifelabs.com

APPOINTMENTS ARE REQUIRED FOR THE FOLLOWING TESTS:Call to schedule an appointment Mon - Fri from 9am - 5pm604-412-4495 or Toll Free 1-855-412-4495

• Ambulatory Blood Pressure• DOT/non-DOT Drug Screen• Holter Monitor• Lactose Tolerance/Hydrogen Breath Test• Paternity / DNA• Semen Analysis

APPOINTMENTS ARE AVAILABLE BUT NOT REQUIRED FOR THE FOLLOWING TESTS:• Legal Drug Screen• Panorama Pre-Natal Screening Test

For tests not listed above, you may arrive without an appointment OR schedule an appointment at a LifeLabs location online at www.lifelabs.com.

Kamloops - St. Paul135 - 546 St. Paul Street 8:00 to 4:00 (250) 374-5638

Kamloops - Nicola 202 - 321 Nicola Street 8:00 to 3:00 (250) 372-0588

Kamloops - Tranquille1 - 685 Tranquille Road 7:00 to 4:00; (Sat. 7:00 to 12:00) (250) 376-4165

Kamloops - Harrison1966 Harrison Way 8:00 to 4:00 (250) 377-7504

Prince George110 - 1669 Victoria Street 7:00 to 4:00; (Sat. 7:00 to 12:00) (250) 562-7358

Quesnel15 - 665 Front Street 7:30 to 3:00 (250) 992-5889

Terrace105 - 4634 Park Avenue 8:00 to 4:00 (250) 615-0332

Dawson Creek2 - 705 - 103rd Avenue 7:30 to 3:00 (250) 782-5764

Nelson806 Vernon Street 8:00 to 4:00 (250) 352-6628

Kimberley260 - 4th Avenue 7:30 to 3:30 (250) 427-2108

Scotch Creek2 - 3874 Squilax-Anglemont Road 9:00 to 1:00 (Wed and Fri only)

D2400 (01/18)