Navigation Links
Rapid Rise in PSA Levels a Poor Predictor of Prostate Cancer: Study
Date:2/24/2011

By Jenifer Goodwin
HealthDay Reporter

THURSDAY, Feb. 24 (HealthDay News) -- Blood tests that indicate prostate-specific antigen (PSA) levels are rising rapidly over time are of little use in detecting aggressive prostate cancer and should not be done, a new study indicates.

PSA is a protein produced by cells of the prostate gland. High levels of PSA can be a marker for prostate cancer, although it's far from a perfect screening tool, experts say. Men with both high and low levels of PSA can have cancer or not have cancer.

The thought was that since high PSA levels are correlated with prostate cancer, rapidly rising levels of PSA, called "PSA velocity," from one year to another would also be an indicator of prostate cancer.

However, the new study found that PSA velocity doesn't add any useful information beyond what physicians can already tell from other methods of prostate cancer screening, including the one-time PSA level test and digital rectal exams.

Current screening guidelines that recommend biopsies for men who have high PSA velocity but no other signs of prostate cancer -- such as a suspected abnormality during a digital rectal exam or high PSA level during a single test -- are leading to many unnecessary biopsies, the researchers said.

"We found there was no strong association between PSA velocity and prostate cancer, and virtually none with aggressive prostate cancer," said study author Andrew Vickers, of Memorial Sloan-Kettering Cancer Center in New York City. "The velocity didn't add anything more to detecting aggressive prostate cancers."

The study is published online Feb. 24 in the Journal of the National Cancer Institute.

The whole issue of prostate cancer screening -- including the PSA test, the digital rectal exam and PSA velocity -- has been controversial, said Dr. Otis Brawley, chief medical officer of the American Cancer Society (ACS).

Part of the difficulty is, while current screening methods are good at detecting cancer, they can't distinguish between aggressive, life-threatening prostate cancers and those that are slow-growing and relatively benign. And many prostate cancers are just that -- of little risk to men during their lifetimes, Brawley said.

Current ACS prostate screening cancer guidelines recommend that men make an informed decision with their doctor about whether to be tested for prostate cancer. "Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment," according to the ACS.

As for PSA velocity, the ACS doesn't have a position on what PSA velocity warrants a biopsy.

But the National Comprehensive Cancer Network and American Urological Association guidelines do recommend biopsies based on high PSA velocities, even in the absence of an elevated PSA or a suspicious digital rectal exam, according to background information in the study.

And many internal medicine and primary-care doctors, in part because of fears of litigation, do order biopsies based on fast-rising PSA levels, Brawley said.

"It's something that has become almost a community standard. If a guy has a PSA of .8 last year, and a year or so later you've repeated it and it's 1.9, because it has increased by a factor of 1 he gets sent to biopsy," Brawley said.

In the study, researchers used data on more than 5,500 men in their 60s and 70s who took part in a drug trial for a prostate cancer prevention drug. The men in the study were all from the placebo arm, meaning they had not received the drug. As part of the trial, all of the men agreed to have a biopsy at the end of the trial, needed or not.

Researchers did find a statistical association between PSA velocity and the chances of a biopsy coming back cancerous. But when they factored in other things that can influence risk, including a family history of the disease, being older, being black, PSA level and results of a digital rectal exam, there was virtually no association between PSA velocity and biopsy outcome.

"PSA velocity measurement is not useful," Brawley said.

Grace Lu-Yao, a cancer epidemiologist at the Cancer Institute of New Jersey who wrote an accompanying editorial, said she agreed with the authors' conclusions that PSA velocity does not seem to be a good predictor of prostate cancer.

In addition, tracking PSA levels overtime can also cause anxiety to men, who often worry if their PSA level has suddenly shot up.

"According to the data, PSA velocity does not add any value, but it may add more anxiety," Lu-Yao said.

More information

The National Cancer Institute has more on the PSA test.

SOURCES: Andrew Vickers, Ph.D., associate attending research methodologist, department of epidemiology & biostatistics, Memorial Sloan-Kettering Cancer Center, New York City; Otis Brawley, M.D., chief medical officer, American Cancer Society; Grace Lu-Yao, Ph.D., M.P.H., cancer epidemiologist, The Cancer Institute of New Jersey; Feb. 24, 2011, Journal of the National Cancer Institute, online


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Hospitals introduce family-activated rapid response programs
2. New indicator found for rapidly progressing form of deadly lung disease
3. New Tool for Rapid Screening of Dementia Shows Promise
4. JAK inhibitor provides rapid, durable relief for myelofibrosis patients
5. Human embryonic stem cells purified in new, rapid technique
6. June 27th Is National HIV Testing Day-New York Celebrity Dentist Offers Free Oral Rapid HIV Testing In the Dental Office
7. Ellsworth Adhesives Is Adding PRC Rapid Seal Product Line Offering
8. Center for Medicare and Medicaid Innovation must implement payment reforms rapidly
9. Self-directed behavioral IBS treatment rapidly relieves even the most severe symptoms
10. Rapid analysis of DNA damage now possible
11. Nonmedical treatment may rapidly relieve severe IBS symptoms
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Rapid Rise in PSA Levels a Poor Predictor of Prostate Cancer: Study
(Date:4/28/2016)... Portland, Maine (PRWEB) , ... April 28, 2016 , ... ... of death and principal determinant of childhood mortality. This is particularly true in underdeveloped ... A lecture at the University of New England’s campus in Tangier, Morocco, will examine ...
(Date:4/28/2016)... ... 28, 2016 , ... Cognizin® Citicoline is one of three ... the Healthy Ageing category, Cognizin® is being considered for this prestigious honor due ... include everything from antioxidants, lipids, proteins, and botanicals. NutraIngredients will choose a winner ...
(Date:4/28/2016)... ... April 28, 2016 , ... The ... Education and Anzu®, developers of the AnzuMedical™ Knowledge Sharing and Collaboration Platform™ ... Residency Network. The platform is scheduled to launch in July 2016 and will ...
(Date:4/28/2016)... ... April 28, 2016 , ... April, 28, 2016 – ... in Physical Medicine and Rehabilitation by Philadelphia Magazine. , Philadelphia Magazine’s annual Top ... surveying physicians and medical leadership across the country. These select individuals nominate outstanding ...
(Date:4/28/2016)... ... 28, 2016 , ... Starting today, households across the United ... Medical Prescription Assistance Program. They are customized to reflect the specific health needs ... a ready-to-use, state-themed card and, in the near future, material that highlights savings ...
Breaking Medicine News(10 mins):
(Date:4/28/2016)... , April 28, 2016  While Abbott,s ... complement the company,s valve repair and stent business, ... also places Abbott more firmly into patient monitoring.  ... the fastest growing device areas, with double-digit growth ... recent report,  Advanced Remote Patient Monitoring ...
(Date:4/28/2016)... April 28, 2016  The blood testing market in ... according to Kalorama Information and The Freedonia Group in ... nucleic acid testing.  The healthcare research firm said that ... developing blood collection stations and in improving testing at ... Information,s report, Blood Testing Market in China ...
(Date:4/28/2016)... April 28, 2016 Oramed Pharmaceuticals Inc. ... pharmaceutical company focused on the development of oral drug delivery ... upcoming PIONEERS 2016 conference, presented by Joseph Gunnar ... New York . Nadav Kidron , ... conference. Presentation Details:   PIONEERS ...
Breaking Medicine Technology: