PSA Scores Provide A Very Good Indication Of The Presence of Aggressive Prostate Cancer

The Prostate Specific Antigen (PSA) test is a blood test which is commonly used as a screening test to detect the presence of a swollen prostate gland and of prostate cancer. Although the test cannot by itself be used for diagnosis it is an excellent indicator and, in combination with other screening tests, PSA test can suggest the need for further investigation.

The PSA test is normally recommended for men in high risk groups (such as those with a family history of prostate cancer) from the age of around 40 to 45 and for men in general after they reach the age of 50.

An isolated PSA test will give a snapshot of prostate specific antigen levels in the blood and may show a problem immediately if you record a particularly high PSA score. In the majority of cases however, and where a prostate problem may be in its early development, a single PSA test result will prove to be inconclusive and a follow-up test will normally be recommended a few weeks later. Indeed, if possible PSA testing ought to be carried out at regular intervals 2 or 3 times every year so PSA levels can be plotted over time.

As long as you record a normal PSA score then all is well, but when your PSA levels begin to increase they have to be monitored closely. The speed with which PSA levels increase is often called the 'PSA velocity' and as long as the increase is steady and the velocity slow then it is again frequently enough simply to watch the situation as many things can influence levels of PSA and evidently increasing levels will frequently be seen to fall back to normal in time.

However, if PSA levels begin increasing rapidly and the velocity is fast then further investigation is certainly required.

PSA testing and monitoring has been carried out for some time but, in spite of the fact that the test has always been thought of as a good indicator of the requirement for further investigation, it was not until very recently that we have been able to link specific PSA velocity figures to prostate cancer in a way which can indicate the aggressiveness of a cancer.

In a recent study data about 950 men with prostate cancer who had undergone either surgery of radiation treatment at four hospitals between 1988 and 2004 was scutinized.

In every case the patients had been diagnosed with aggressive prostate cancer on the basis of a single very high PSA score, a noticeable increase in PSA velocity during the year prior to diagnosis, a biopsy indicating signs of an aggressive cancer at cellular level, the presence of an advanced stage tumor or a mix of two or more of these markers.

The study also looked in detail at the outcomes for all 950 men and discovered that a rapidly increasing PSA score which jumped by 2 or more points in a year was the best indicator or the presence of an aggressive cancer.

Up until now we have been able to associate increasing PSA levels with the possible presence of prostate cancer but have had to guess to some extent about whether or not such a cancer is likely to be aggressive and require correspondingly aggressive treatment.

However, now we can say with reasonable certainty that if a PSA score rises by more than 2 points in a year then prostate cancer is almost certainly aggressive and requires quick and vigorous treatment.