PSA Levels Provide A Very Good Indication Of An Aggressive Prostate Cancer
The PSA test is a simple blood test that is commonly performed to screen for the presence of benign enlargement of the prostate gland and of prostate cancer. While the test cannot in itself be used for diagnosis it is a very good indicator and, together with other screening tests, PSA testing can point to the need for further investigation.
PSA testing is normally recommended for men in high risk groups (such as those with a family history of prostate cancer) from the age of around 40 to 45 and for men in general after they reach 50 years of age.
An isolated test will provide a snapshot of of the level of prostate specific antigen in the blood and might indicate a problem immediately if you have especially high psa numbers. In the majority of cases however, and where a prostate problem is in its early development, a single test result will prove to be inconclusive and a second test will normally be recommended in a few weeks time. Indeed, ideally testing ought to be carried out at regular intervals 2 or 3 times every year so PSA levels may be seen over time.
Provided that you register a normal PSA score then all is well, but when your PSA levels begin to increase they have to be watched very closely. The speed with which PSA levels increase is often called the 'PSA velocity' and if the increase is steady and the velocity slow then it is once again frequently enough simply to watch the situation as various things can effect PSA levels and seemingly increasing levels will frequently return to normal given time.
However, when PSA readings begin increasing rapidly and the velocity is said to be fast then further investigation is needed.
This pattern of PSA testing and monitoring has been performed for some time but, although the test has always been thought of as a good indicator of the need for further investigation, it was not until quite recently that we have been in a position to link specific PSA velocity figures to prostate cancer in a fashion that can predict the aggressiveness of a cancer.
In a study carried out recently data from 950 men with prostate cancer who had undergone either surgery of radiation treatment between 1988 and 2004 at four hospitals was carefully analyzed.
In all cases the patients had been diagnosed with aggressive prostate cancer on the basis of a single very high PSA score, a noticeable increase in PSA velocity in the year prior to diagnosis, the results of a biopsy showing an aggressive cancer at cellular level, the presence of an advanced stage tumor or a mix of two or more of these indicators.
The study also looked at the post-treatment outcomes for all of the patients and discovered that a rapidly increasing PSA score that rose by 2 points or more in a twelve month period was the clearest indicator or the presence of an aggressive cancer.
Until now we have been able to associate increasing PSA levels with the possible presence of prostate cancer but it has been necessary to guess to some extent about whether or not such a cancer is likely to be aggressive and require equally aggressive treatment.
Now however we are able to say with a fair degree of certainty that where a PSA score increases by 2 or more points in a year then prostate cancer is almost certainly aggressive and requires speedy and vigorous treatment.
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