JH study dispels PSAv doubts!

Latest Research of PSA Velocity
as a Predictor of Prostate Cancer

Clinical studies involving carefully selected groups of men have indicated that measuring PSA velocity -- that is, the rate at which prostate-specific antigen (PSA) levels rise over time -- is a more accurate predictor of whether a man may have prostate cancer (and require a biopsy) than the results of a single PSA test.

To test this theory in a "real world" setting, researchers tracked 219,388 men who were members of the Kaiser Permanente health plan in southern California from 1998 to 2008. On average, each man had five PSA tests during that period.

By the end of the study period, 10,035 men had developed prostate cancer. PSA velocity accurately predicted which men would develop prostate cancer and was significantly more accurate than a single PSA measurement in predicting which men would develop aggressive disease.

Just what does aggressive Cancer mean? I am already a G7. Does this mean, despite being low or intermediate risk, your apt to have EPE, ECE, or some type of conduit for mets?

The HW debate on this topic usually ends in a draw with the wisdom falling on the latest research. Well folks here is some of the latest research with a very large sample group.

Post Edited (browntrout) : 12/22/2014 1:55:20 PM (GMT-7)

and another favorite hobby on this forum, finding fault in the studies...

:)

onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2012.11651.x/abstract

@browntrap,

I think 'In the shop' was just having a little fun with 'Steve n Dallas'.

Based on my limited knowledge gained in the past two months, I'd say velocity is the #1 predictor.

In my case, the local hospital does a free prostrate screening and sent me a letter in the mail saying my test (it was 4.0) was "Normal" and something like "no need to follow up".

However, what they didn't take into account is that my PSA had risen from 2.5 to that 4.0 in like eight or nine months. That's pretty significant.

My primary doc was very alarmed by the rise (test from his office was 4.5).

Forgive me for a touch of OCD today but I am struggling with the word "confirms" in the subject line. Reading the story I might have said "dispels PSAv doubts"

Thanks, I'm better now.

By my reading the comparison was between PSA velocity (involving multiple tests over time) vs comparing a single PSA reading against some standard level to assess risk. Since they talk of the two measures predicting the need for a biopsy (among other things) they aren't saying anything about a Gleason score which is only available after a biopsy.

While Gleason score isn't a perfect indicator of cancer aggressiveness it is probably good enough for our purposes here. When they say that PSA velocity can predict aggressive cancer diagnoses they are also saying that it will predict a high Gleason score, too.

As to your slightly different question about what PSAv means to a man who has already been diagnosed and already has a Gleason score, I would think that, for the most part, a Gleason score is a much better measure of cancer aggressiveness. On the other hand Gleason scores determined by biopsy are frequently wrong -- they are upgraded or downgraded by post-op pathology reports for those men who have surgery -- and it wouldn't hurt anything for men with low Gleason scores but high PSA velocity to be a bit more vigilant.