Another technique is called PSA velocity—its rate of change from year to year. PSA velocity is a fluid continuum, not a cut-and-dried, one-shot reading. It’s like having a prostate barometer—your doctor doesn’t have to wait for PSA to reach the magic number of’4- What matters instead is an average, consistent increase of greater than 0.75 nanograms per milliliter per year, over the course of three readings spaced no closer than 12 to 18 months apart. (Say a man’s PSA level went up from 1.2 to 2.3 to 3.6 over 24 months—clearly, something’s happening here, and it needs to be investigated.)

Finally, some investigators use age-specific ranges for PSA. The theory here is that, as a man ages, his prostate gets bigger. Therefore, why should the PSA cutoff point be the same for a 40-year-old man as for an 80-year-old man—who probably has a higher PSA anyway, due to BPH? Advocates of this approach recommend a cutoff of 2.5 for men in their forties, of 3.5 for men in their fifties, of 4.5 for men in their sixties, and of 6.5 for men in their seventies. Using this system, doctors hope to detect more cancers in younger men, and to prevent unnecessary biopsies in older men.

Further study should determine which of these techniques is most useful. Once a diagnosis of prostate cancer has been made, the next step is to determine the cancer’s stage—in other words, how far has it spread?

What tests do you need? For most men, the only imaging study that’s really necessary is a bone scan. Under some circumstances, further tests—an MRI or CT scan, or lymph node evaluation—may be advised. However, for most patients with a negative bone scan (which indicates that the cancer has not spread to the bone), information from the physical examination, the grade of the tumor (using a system called the Gleason score, which is discussed in this chapter), and the PSA findings can enable physicians to estimate the extent of cancer—and therefore, a man’s likelihood of cure. And then this crucial determination helps a man select which form of treatment is best for him.


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Posted on Monday, March 30th, 2009 at 7:52 am and is filed under Men's Health-Erectile Dysfunction. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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