PSA Velocity Predicts Risk of Prostate Cancer Death

Prostate-specific antigen velocity (PSAV), or the rate at which the amount of PSA in a man's blood increases, is an accurate gauge of tumor aggression and danger, even when prostate-specific antigen (PSA) levels are so low as to not warrant a biopsy.

PSA is a protein in the bloodstream of men that is produced by the prostate gland and found at increased levels in those with prostate cancer. In a new study, Dr. H. Ballentine Carter, director of the Johns Hopkins Division of Adult Urology at the Brady Urological Institute (Baltimore, MD, USA), and colleagues demonstrated that PSAV can also identify men with life-threatening disease at a time when it is still curable. Findings of the study were published in the October 2006 Journal of the U.S. National Cancer Institute.

Using serum samples dating as far back as 1958, frozen as part of an ongoing randomized health study of men, Dr. Carter and his team determined PSAV in 980 of the study participants until May 2005. They found that the PSAV determined at a time when PSA levels would not have triggered a biopsy was predictive of death from prostate cancer 20 to 30 years later.

"Our data provide a further argument for PSA testing that begins relatively early in life, when PSA levels are usually lower and prostate enlargement is not a confounding factor in diagnosis,” said Dr. Carter, lead author of the study. "We would recommend that men at around age 40, not 50, have their PSA checked to develop a baseline against which to compare future changes, since even a slight rise in PSA may indicate a potential for cancer down the road.”

Dr. Carter concluded that the rate at which a man's PSA rises may be more important than any absolute level for identifying men who will develop life-threatening cancer while their disease is still curable. In addition, PSAV could be a useful method for identifying those men with a prostate cancer that could be safely monitored--an approach termed active surveillance.



Related Links:
Johns Hopkins Division of Adult Urology at the Brady Urological Institute