Table of Contents

Chapter 1: What Does a Diagnosis of Prostate Cancer Mean?

i. The Role of PSA Velocity

One of the benefits of nomograms is that they allow doctors to take into account a number of different factors, including PSA and Gleason score, that might contribute to your outcomes. But what we’ve been finding over the past few years is that certain factors can help predict outcomes by themselves, regardless of any other factors. For example, researchers have been looking more closely at how fast PSA rises, or the PSA velocity, and have noticed that in some men, the PSA rises rapidly, while in others, it rises slowly.

After looking at PSA velocity in a few hundred men, researchers found something incredibly interesting: men whose PSA rose by more than 2.0 ng/mL per year before undergoing surgery or radiation therapy tended to have worse outcomes overall. They were more likely to have disease that had already spread,more likely to die from prostate cancer, and even more likely to die from other diseases.

That doesn’t mean that men with rapidly rising PSA values will die from prostate cancer, or that their cancers will progress to advanced stages immediately. It also doesn’t mean that we should ignore all other factors and use only PSA velocity to predict prognosis. What this does mean is that men who fall into this category need to follow up more regularly with their doctors.