PSA velocity

Thank you for that piece, I intend to study that one. Very informative, something for all newly diagnosed and men concerned about Pca for them selves or others. Medved, you are the gentleman that does not have a diagnosis of pca, I believe. Your participation in the forum, is studied and appreciated.

if you want to read the articles on the other side of this issue, look up Dr. Catalona's writings.

The argument in essence is that PSAV is a significant predictor if taken on its own without other data, but is not a significant predictor after other factors are taken into account. For example, does PSAV at the biopsy time predict who will relapse after RP? The argument is that if you only looked at PSAV it would, but that if make a prediction based on things like margin status, lymph node status, overall PSA level, and percent of positive cores, then the addition of PSAV does not provide any ADDITIONAL predictive power above and beyond those factors. (that is what multiple regression testing is all about.)

This just confirms that psadt is a big deal for us pt3b guys!
Bob

Medved,
Like Logo, I appreciate that you have provided us with the latest information on PCa although you don't have it. I've read your threads and posts and wish you well in your fight on another front.
I am completely confused by the article since it seems to "debunk" the widely held believe that PSA velocity and/or PSADT adds value in making decisions about whether to biopsy. Maybe my pcp was right in ignoring my psa rise from 2.72 to 4.89 in 13 months and then "monitoring" me for another year and a half until I developed emergency symptoms. His response to a staff attorney was that he believes in a "conservative approach". He is employed by an organization whose current guidance statement is that "harms can be minimized with no reduction in benefits if active treatment is targeted to men with PSA values of 10 or more"..

My old degree in English was of no value in trying to wade through this "stuff"; I feel sorry for doctors trying to make sense of this article! Many men/ladies on this forum are highly educated or at least have a high degree of common sense. Currently our government pans both the psa test and dre so I presume that the law of the land is to wait until men are diagnosed by symptoms with incurable "high risk" prostate cancer. Sure there are men like Jerry L and others that had high gleasons that didn't emit any psa so the test was of little value to them, but they realize that the tests are of value in detecting the disease at an early stage in many men that can be cured. Again, I appreciate Jerry's efforts to have the USPSTF's recommendation reviewed although the tests were probably of little or no value to him; I call it compassion!
I was waiting for Logo's "studied" response to this article but I can only assume than it won't be forthcoming; arguably he probably was sidetracked by reading Joyce's "Ulysses". I believe that the small atoll where he lives is part of the US so he could vote if he desired to--LOL. A hard nut to crack!
Bill

I don't buy this report at all. Completely goes against what my urologist said in 2008, and my oncologist's view since I have known him. He firmly believes in the danger of high PSA velocity, especially in the year before one is diagnosed. My own "Gleason 7" case has been the poster board example of how all this works with extreme PSA velocity.

I stand by their views on this subject. However, when we are talking about PSA doubling from .002 to .004, just as an example, it doesn't mean as much as some view it. Mostly because of the minute amount of PSA we are talking about.

Then in a case such as mine, post surgery and post radiation failure, the rate of climb and the actual number means less and less to the doctor as far as treatment goes. One reason my doctor is not interested in doing PSA's very often with me, as it's not going to change what he does or doesn't do.

Like all things PC, what one experts swears to, the next expert disagrees. Too bad really, as it makes men's choices even more difficult to make.

David