Prostate cancer is the second-leading cause of cancer death in men and kills nearly 30,000 men each year. The lifetime risk of being diagnosed, one in six, is higher than the one in eight risk of breast cancer in women. A new study shows the rate of rise in prostate-specific antigen levels, or PSA velocity, before prostate cancer diagnosis is a more powerful indicator of eventual death from prostate cancer than the actual PSA level itself.
Researchers found an annual PSA velocity of more than 2 nanograms per milliliter was linked to a significantly increased risk of death even after having a radical prostatectomy. Results from various studies show , PSA velocity measurements during the year before diagnosis can help identify the potential aggressiveness of the cancer. Men with a sharp PSA increase are more likely to have a potentially lethal cancer while those with milder increases are more likely to have a less aggressive cancer that is more amenable to treatment.
Hence researchers recommend that since deaths from prostate cancer begin to occur in men in their 40s, men should begin tracking their PSA levels at age 40 to recognize a sharp rise. They also recommend biopsies be conducted when PSA levels rise .75 nanograms per milliliter or more over a year. Other indications for a biopsy are a PSA level higher than 2.5 nanograms per milliliter, which is lower than the initial recommendation of four nanograms per milliliter.