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The Link Between PSA Velocity and Aggressive Prostate Cancer

2 March 2011

A recent study has found that rapidly increasing PSA levels, or PSA velocity, are not an effective method for determining whether a patient has an aggressive life-threatening form of prostate cancer or a slower developing form of the disease.

I mentioned PSA levels last week when discussing the supposed benefits of pomegranate extract in slowing the growth of prostate cancer.  What the study found was that men who took the extract slowed the expected doubling time of their PSA levels, which may indicate a slower progression of the disease.

What I pointed out regarding that study is that the reduced PSA velocity doesn’t necessarily equate to a better outcome for patients, and this new study is effectively stating the same.  While I believe PSA velocity is a valuable tool in determining the best course of treatment for my patients, I do not use it as my sole method for doing so for the reasons stated above.

Doctors should use a variety of methods for diagnosing and monitoring prostate cancer in addition to PSA levels such as digital rectal exams (DRE), Gleason scores, and of course, they need to pay attention to a patient’s family history.  There is a strong genetic factor to prostate cancer which should not be ignored.

While PSA levels and velocity may not be a perfect method for finding and monitoring prostate cancer, I do believe it is helpful when combined with the rest of the knowledge we have about a patient.   We’re still learning of other possible risk factors and developing new methods for diagnosing the disease and determining how aggressive a patient’s cancer is.  One day something definitive will come along to replace PSA levels but for now I think it’s still important to keep in our lineup of tools.


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