PSA: an update.
We know there is no cut-off of PSA that can rule out prostate cancer, a little more than zero and you may be at risk, the problem is to know if you are at risk of dying from of this disease or not. So PSA is not so specific, and we know also that between 2 and 8 ng/ml there is no big difference, and that PSA is partly related to the transition zone. PSA is related to age and to the size of the transition zone, which is BPH, so you have to exclude this, and keep in mind the reference data that Joe Oesterling published in the JAMA in 1996 which is that PSA is age dependeant. I would say that for patients who are at high risk of dying of the disease, those who have a life expectancy of 10 or 15 years, that are under 60 and have high Gleason, if you consider treatment, then you have to treat them early if you want to cure them. But let's not overtreat patients who have no risk or limited risk of dying from prostate cancer, let's be more conservative. The difficulty is to define criteria. Age, of course, is the major criteria. High Gleason, i.e., a Gleason with pattern 4 or 5, and PSA velocity is very important.
Schulman
Claude
C
Department of Urology, University Clinics of Brussels, Erasme Hospital, Belgium. claude.Schulman@ulb.ac.be
D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*
D017430:Prostate-Specific Antigen