UPDATE - Issue 28 - Winter 2007
PSA Velocity Predicts Risk of Cancer Death
Many men know that if their PSA is less than 4.0ng/ml they are very unlikely to have prostate cancer needing treatment. Now it is suggested that PSA velocity - the rate at which the hormone level is changing - is a better guide.
It can be evaluated at any time. Those patients who have a modest or borderline PSA reading and appear to be at low risk should be treated as high risk if their PSA velocity is greater than 2ng/ml per year.
The PSA velocity can be measured years earlier too. In last November's Journal of the National Cancer Institute, data is presented by Dr Carter and colleagues from Johns Hopkins. This shows that PSA velocity 10-15 years before diagnosis was associated with prostate cancer survival 25 years later. If the PSA velocity was less than 0.35ng/ml per year they were less likely to die of prostate cancer than if it was above this figure.
The rate of cancer deaths for men whose annual PSA velocity was above 0.35ng/ml was 1,240 per 100,000 person-years, compared to 140 per 100,000 person-years for men with a PSA velocity below 0.35ng/ml per year.
The implication, Dr. Carter and colleagues reported, is that 'PSA velocity may help identify men with life-threatening prostate cancer during a period when their PSA levels are associated with the presence of curable disease.'