Johns Hopkins researchers have found that PSA velocity can predict prostate cancer many years in advance when it is more curable.
PSA velocity is a measurement of how quickly a man's prostate-specific antigen (PSA) level rises from one year to the next. A rapid rise in PSA (a high PSA velocity) suggests the presence of prostate cancer. A study from Johns Hopkins and the National Institute on Aging found that an increase in PSA level of more than 0.75 ng/mL per year was an early predictor of prostate cancer in men with PSA levels between 4 ng/mL and 10 ng/mL.
PSA velocity is especially helpful in detecting early cancer in men with mildly elevated PSA levels and a normal digital rectal exam. It is most useful in predicting the presence of cancer when changes in PSA are evaluated over at least one to two years. In a study reported in The New England Journal of Medicine, a rapid rise in PSA level (more than 2 ng/mL) in the year before prostate cancer diagnosis and surgical treatment predicted a higher likelihood that a man would die of his cancer over the next seven years.
Now a study by Johns Hopkins researchers shows that PSA velocity can predict which men will develop life-threatening prostate cancer many years later. The study subjects were 980 men who had been long-time participants in the Baltimore Longitudinal Study of Aging, sponsored by the National Institute on Aging.
The researchers found that PSA velocity measured 10–15 years before prostate cancer diagnosis predicted their cancer-related survival 25 years later. Ninety-two percent of the men whose PSA velocity was 0.35 ng/mL or less per year had survived, compared with 54% of those whose PSA velocity was greater than 0.35 ng/mL per year. About five times more men in the higher PSA–velocity category died of prostate cancer than in the lower-velocity category. When PSA velocity was being measured, most of the men’s PSA levels were below 4.0 ng/mL, the traditional cutoff point for lower risk. These results suggest that PSA velocity may help identify high-risk men early, when their disease is more curable. This data was reported in the Journal Of The National Cancer Institute (Volume 98, page 1521).
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Users and editors may post comments here at their own discretion. The views expressed do not constitute medical advice and do not represent the position of Johns Hopkins Medicine or University Health Publishing, which has no responsibility for its content.
PSA is not an absolute test, I have prostate cancer and my PSA is .75, should have a DRE yearly is over age of 50
Posted by: silversmoke | September 1, 2007
I wish the medical community would stop calling the current options available to prostate cancer sufferers a "cure". What is offered today by western medicine are ways of ridding a man of prostate cancer by removing or destroying his prostate, and, thereby, fundamentally changing his sex life, and very possibly leaving him incontinent. As a young (51) man with a positive biopsy, I'm not exactly ready to give up my virility, and I would hardly call a choice between mutilation or death, a "cure".
Posted by: zbearx | September 1, 2007
Although not a "cure", if Prostate Cancer is detected in early stage, and if certain qualifications are met, pro-actively following the Johns Hopkins' "Expectant Management with Curative Intent" program, led by Dr. H. Ballentine Carter, may preclude the need for surgical removal of the prostate, or alternate options.
Posted by: berg07417 | September 1, 2007
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