Washington – How fast a man’s PSA level is rising – even before it’s high enough to trigger a doctor’s alarm – may signal that he has a life-threatening form of prostate cancer when the tumor is still small enough to be curable, researchers said Tuesday.
A new study backs a small but growing trend of evaluating the common blood tests in a more in-depth way, in hopes of better predicting who has aggressive cancer that needs aggressive treatment and who just needs monitoring.
The study is far from proof that making health decisions based on so-called “PSA velocity” can save lives, but the findings suggest men should consider getting a first PSA test around age 40, instead of the more usual 50, to use as comparison for future changes, contends Dr. H. Ballentine Carter of Johns Hopkins University, the study’s lead author.
“The rate at which a man’s PSA rises may be more important than any absolute level for identifying men who will develop life-threatening cancer while their disease is still curable,” he said. “This is a test that doesn’t just diagnose prostate cancer. It diagnoses prostate cancer that’s going to actually cause harm.”
PSA tests are a recommended way to screen for prostate cancer, but they’re imprecise. Too much PSA, or prostate-specific antigen, in a man’s blood can indicate that he has either a benign enlarged prostate or cancer.
Only a biopsy can tell the difference.
It’s not even clear when is the best time to do a biopsy. Some men have cancer despite a “normal” PSA count of 4 or below, but routinely biopsying men with low PSA would worsen another problem, overdiagnosis.
Many specialists say too many men today are undergoing side-effect-prone treatment for tumors too small and slow-growing to ever threaten their lives.
The new study, published in the Journal of the National Cancer Institute, suggests that evaluating how fast a man’s PSA level rises may help that tricky balancing act of when to biopsy and how aggressive to treat.
Some 234,000 U.S. men will be diagnosed with prostate cancer this year, and just over 27,000 of them will die, the cancer society estimates.
