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PSA Changes Over Time Test Predicts Prostate Cancer Risk
The rate at which PSA levels doubled over time was a critical factor for predicting death
in a group of 379 men who underwent surgery for prostate cancer, concludes a report by
Freedland's group published in the July 27, 2005 issue of the Journal of the American Medical Association.
In the same journal, a second report issued by Dr. Anthony D'Amico, chief of radiation
oncology at Brigham and Women's Hospital in Boston, found similar results for a much
more common scenario - men treated with radiation after being diagnosed with prostate cancer.
This second report conclusion is the crucial factor predicting death in the 358 men in that
trial was a two-point rise in PSA readings. Of the 30 deaths in the study, 28 occurred in men
whose PSA rose by more than two points in the year before diagnosis.
Doctors may need to stop focusing on single test results, both studies suggest.
"A single reading is like looking at one snapshot of a race," said Freedland, a clinical
instructor in urology at the Johns Hopkins Hospital in Baltimore. "Watching the PSA change
over time gives you a much better picture."
For men health, both reports have implications that start with their annual physical exam,
From now on, a PSA test should be part of that exam, and an increase of two points from the
original level, no matter how high or low, indicates that a biopsy should be done to detect
the eventual cancer.
Once cancer is detected, aggressive treatment may be advisable for those men who experienced
a two-point PSA increase before diagnosis. Specifically, hormonal therapy should be added
to other standard treatments, such as radiation therapy.
NOTE: The Information on this site is provided for information only, and is not meant to substitute for
the advice of your own physician or other medical professional.
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