[Hopespringpcsg] FW: Prostate Disorders: What We Can Learn by Measuring PSA Velocity

Wed Jun 5 16:06:17 EDT 2013

Hi all:

FYI, see below.

Glen

From: Johns Hopkins Health Alerts
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Sent: June 5, 2013 6:02 AM

Subject: Prostate Disorders: What We Can Learn by Measuring PSA Velocity

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 Johns Hopkins Prostate Disorders Health Alert
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What We Can Learn by Measuring PSA Velocity
<http://www.johnshopkinshealthalerts.com/alerts/prostate_disorders/Measuring
-PSA-Velocity_6566-1.html?ET=johnshopkins:e111516:416023a:&st=email&s=EPH_13
0605_001> 

The prostate-specific antigen (PSA) test measures an enzyme produced almost
exclusively by the glandular cells of the prostate. It is secreted during
ejaculation into the prostatic ducts that empty into the urethra. PSA
liquefies semen after ejaculation, promoting the release of sperm. Normally,
only very small amounts of PSA are present in the blood. But an abnormality
of the prostate can disrupt the normal architecture of the gland and create
an opening for PSA to pass into the bloodstream. Thus, high blood levels of
PSA can indicate prostate problems, including cancer. PSA blood levels are
expressed as nanograms per milliliter (ng/mL). 

PSA velocity is a measurement of annual changes in PSA values, which rise
more rapidly in men with prostate cancer than in men without the disease. A
study from Johns Hopkins and the National Institute on Aging found that an
increase in PSA level of more than 0.75 ng/mL per year was an early
predictor of prostate cancer in men with PSA levels between 4 ng/mL and 10
ng/mL.

PSA velocity is especially helpful in detecting early cancer in men with
mildly elevated PSA levels and a normal digital rectal exam. It is most
useful in predicting the presence of cancer when changes in PSA are
evaluated over at least one to two years. In a study reported in The New
England Journal of Medicine, a rapid rise in PSA level (more than 2 ng/mL)
in the year before prostate cancer diagnosis and surgical treatment
predicted a higher likelihood that a man would die of his prostate cancer
over the next seven years.

Moreover, a Johns Hopkins study published in the Journal of the National
Cancer Institute found that a man's PSA velocity 10 to 15 years before he
was diagnosed with prostate cancer predicted his survival from the disease
25 years later. In the study, 92 percent of men with an earlier PSA velocity
of 0.35 ng/mL or less per year had survived, compared with 54 percent of men
whose PSA velocity was greater than 0.35 ng/mL.

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The OTHER side effect of radical prostatectomy

Many men undergoing a radical prostatectomy for prostate cancer focus on
erectile dysfunction as the major complication they face. But in fact,
following prostate surgery, men often confront another potentially more
troubling complication: urinary incontinence. By some estimates, 50 to 60
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