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PSA Velocity: It's Not the Number, but What It Does!

So, basically, to sum up: You can’t just look at a PSA number and know very much at all. It’s like looking at a Most Wanted photo and saying, “That guy looks guilty,” or “He has kind eyes! He’s probably been framed! He’s no criminal.” No self-respecting detective would ever try to get a warrant based on appearance. You investigate first. This is why you study PSA, watch what it does, and if it’s going up, check the free PSA, with a “second-tier” PSA test such as the Prostate Health Index (PHI); you also may need a biopsy.

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Articles of Interest

PSA velocity in prostate cancer screening—the debate continues

Prostate cancer screening in the PSA era is controversial and the most appropriate measures for diagnosis are widely debated. Vickers and colleagues recently suggested that using PSA velocity in screening offers little benefit compared with traditional markers; however, elimination of this test from practice or guidelines may be premature.

PSA velocity: is it important to prostate cancer risk

The “New” Prostate Cancer InfoLink cannot tell you which is the correct answer to this controversy... On the other hand, we can advise readers that PSA velocity has clearly been shown to be predictive of risk for progression after first-line treatment.

Prostate-specific antigen (PSA) velocity: a test of controversial benefit in the era of increased prostate cancer screening

The current study suggests that PSAV is not as beneficial a screening test as previously believed; however, that does not mean that PSAV should be disregarded altogether. By their own estimates, using PSAV would help diagnose more cancer and more aggressive cancer.

Prostate-Specific Antigen Trends Predict the Probability of Prostate Cancer in a Very Large U.S. Veterans Affairs Cohort

In the evolving prostate cancer screening paradigm using new technologies, PSA is the low-cost way to begin screening a population of men. PSA trends may help identify men at elevated risk who could be referred for further evaluation, even at low to moderate PSA levels.

PSA Velocity Does Not Improve Prostate Cancer Detection

A rapid increase in prostate-specific antigen (PSA) levels is not grounds for automatically recommending a prostate biopsy... “Overall, PSA velocity did not importantly add predictive accuracy to a standard predictive model or to just PSA alone,” wrote Andrew Vickers, Ph.D., and his colleagues from Memorial Sloan-Kettering Cancer Center (MSKCC). “We found no reason to believe that implementation of the guideline would improve patient outcomes; indeed, its use would lead to a large number of unnecessary biopsies.”

What is PSA Velocity?

PSA velocity is the rate at which your PSA level increases from year to year. This rate of change in PSA levels over time, can give crucial information to a doctor about your potential for cancer. A rapid increase in PSA or PSA doubling time can be a sign of a rapidly growing cancer.