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PSA kinetics

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'PSA kinetics'

  • PSA velocity (PSAv) refers to the absolute rate of PSA change over time

    • evidence has indicated that PSA may need to take into account both age and individual PSA value to optimise interpretation
    • in clinical practice, a minimum of three values is required over at least 18 months for a meaningful assessment
    • may offer prognostic information as to how an individual prostate cancer may behave after diagnosis with a rise in over 2 ng/ml in the year prior to diagnosis predicting a more aggressive disease course or higher post-therapy relapse rate (D'Amico et al. 2005)

  • PSA doubling time (PSAdt)
    • refers to the time taken for a serum PSA value to double and is also emerging as useful pre-treatment marker of a prostate tumour's biological potential (Klotz 2005)
    • calculated PSAdt of less than 3 years may indicate a more aggressive tumour course

References

  • D'Amico AV, Renshaaw AA, Sussman B, Chen MH. Pre-treatment PSA velocity and the risk of death from prostate cancer following external beam radiotherapy. N Eng J Med 2005; 294: 440-7
  • Klotz L.Active surveillance with selective delayed intervention using PSA doubling time for good risk prostate cancer. Eur Urol 2005; 47: 16-21
  • NICE (May 2019). Prostate cancer: diagnosis and management

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