PSAs....what do they mean? Is there a chart or something?
Rogue
Is there a chart or diagram or something that shows what PSA readings
actually mean? My father has kept a 4-7 for many years and recently
went up to a 9. A man down the street claims to have had a 70 and has
cancer really bad. What are the PSAs and is there something that shows
what these readings mean?
Rogue
Paul I. Roda, M.D., F.A.C.P.
Rogue wrote:
There are many different approaches to Prostate Antigen values. This
protein is secreted in prostate cancer, and in benign hyperplasia. A
marked rise is obviously worrisome for cancer. A slight rise could mean
hyperplasia (which is why some urologists used age or volume adjusted
PSA's.) How old is your father? In elderly patients (elderly being
defined as seventy, seventy five, or eighty depending on who you talk
to) I wouldn't even get a PSA unless the patient had symptomatic bone
mets. This stems from multiple studies that show that treatment of early
prostate cancer may not improve quality life.
If in doubt, get a prostate ultrasound and ultrasound directed biopsy
(if the ultrasound is abnormal). But I would persue a diagnosis of
prostate cancer only in a patient who would benefit from aggressive
treatment (be it radical prostatectomy, brachytherapy, or external beam
radiation) for early stage prostate cancer.
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Alan Peacock
Rogue <rogue...@rocketmail.com> wrote in article
<601k3c$k...@winter.news.erols.com>...
> Is there a chart or diagram or something that shows what PSA readings
> actually mean? My father has kept a 4-7 for many years and recently
> went up to a 9. A man down the street claims to have had a 70 and has
> cancer really bad. What are the PSAs and is there something that shows
> what these readings mean?
>
> Rogue
>
Hi again,
I have found different doctors have different ideas on PSA levels.
The simplest I have found is the patients age divided by ten.
At 48 I had a PSA of 13.8 prior to surgery, 1.3 after, then 0.1 after
radio therapy as well.
PSA can be elevated by various factors, and I have heard of levels of up
to 1500 due to chronic infection & inflammation.
Check the links on my page as per last message, there is some good info
on the PSA levels amongst them.
Kind regards,
Alan
John Booth
: Rogue <rogue...@rocketmail.com> wrote in article
: <601k3c$k...@winter.news.erols.com>...
: > Is there a chart or diagram or something that shows what PSA readings
: > actually mean? My father has kept a 4-7 for many years and recently
: > went up to a 9. A man down the street claims to have had a 70 and has
: > cancer really bad. What are the PSAs and is there something that shows
: > what these readings mean?
: >
: > Rogue
: >
As a lay person I have gleaned the following from my reading.
PSA is the abbreviation for prostate specific antigen. It is a
normal product of the prostate gland.
"Normal" PSA values as a function of age are generally quoted
as follows:
40 - 49 yrs <2.5
50 - 59 yrs <3.5
60 - 69 yrs <4.5
70 - 79 yrs <6.5
the < means "less than"
In advanced cases of prostate cancer the PSA values can rise to
over 1000.
It is important to remember that PSA alone is not a reliable test
for prostate cancer. Other diseases or an injury can cause elevated
PSA's. On the other hand some prostate cancer types do produce much
PSA. Digital rectal exams, biopsies, and other tests are important in
determining the cause of an elevated PSA and the possible presence (or
the absence) of cancer.
An elevated PSA reading should be the signal to actively pursue
further diagnostic tests.
If you have a Web browser I strongly recommend you go to
http://rattler.cameron.edu/prostate/
where you will find a wealth of information on prostate cancer.
Hope this helps.
John
Howard Homler
On 20 Sep 1997 22:52:28 GMT, rogue...@rocketmail.com (Rogue) wrote:
>Is there a chart or diagram or something that shows what PSA readings
>actually mean? My father has kept a 4-7 for many years and recently
>went up to a 9. A man down the street claims to have had a 70 and has
>cancer really bad. What are the PSAs and is there something that shows
>what these readings mean?
>
>Rogue
There are charts, but evaluating the individual, his exam, and his
clinical condition are more important. A person's psa usually goes up
around 0.8 points per year, but it can soar during episodes of
prostatitis, or for younger men, for 48 hrs after sex. Otherwise, a
jump to 9 may indeed raise suspicion of the development of a cancer.
Measuring the "free psa" percentage may give additional probability
estimates of cancer vs. benign findings. Most importantly, may be the
age and overall condition of the patient. Urologists are keenly aware
that sometimes the treatment may do more harm than good, and need to
weigh these factors in deciding what to do next. H2
wym...@voicenet.com
rogue...@rocketmail.com (Rogue) wrote:
>Is there a chart or diagram or something that shows what PSA readings
>actually mean? My father has kept a 4-7 for many years and recently
>went up to a 9. A man down the street claims to have had a 70 and has
>cancer really bad. What are the PSAs and is there something that shows
>what these readings mean?
>Rogue
PSA, of course, means prostate specific antigen. It is a subsatance
produced only by the prostate gland. It is produced by both normal and
carcinogenic tissue. Normal tissue produces 0.5ng/ml per 1cc of
tissue. Carcinoma produces 2.0ng/ml per 1cc.Thus the problem is to
determine if an elevation is caused by enlargement of the prostate or
cancer.
Generally normal readings are age dependent since BPH, Benign Prostate
Hyperplasia, (enlarged prostate) increases with age. One table shows
Age 40-49 PSA 0-2.5
50-59 0-3.5
60-69 0-4.5
70-79 0-6.5 as normal
The rule of thumb is 0-4.0 normal
4.0- 10.0 questionable
>10.0 likelihood of cancer
The real issue is the probability of carcinoma which is dependent on
several diagnostic modalities. PSA, DRE (Digital Rectal Examination)
and TRUS (Trans Rectal Ultra Sound). The more positives the greater
the liklihood of cancer. Any one modality can give both false
positives (indication of cancer when none is present) or false
negatives (indication of no cancer when it is present). Rapidly rising
PSA (PSA velosity) is more significant the absolute value.
All of these are simply predictive tools to determine whether a more
significant diagnostic procedure - needle biopsy should be utilized.
This is the one definitive method to determine if adenocarcinoma of
the prostate is present. Even if it is it may not mean that aggresive
treatment is warranted. One study has shown that a 50 yr old male has
a 40% chance of developing Prostate cancer during his lifetime, a 10%
chance of being diagnosed and a 2-3% chance of dying from it. The
probability of death depends on the speed with which it grows and
whether it stay confined to the prostate. (All well beyond your
original question)
Disclaimer - I am not a doctor but have spent a lot of time on the web
and in medical libaries since first visiting a urologist
you may want to see
www.aconline.org/journals/annals/01mar97/ppcancer.htm
www.wellweb.com/prostate/LOOKDIAG.HTM
http://rattler.cameron.edu/prostate/partin2form.html
Good luck Wymet
Ralph Valle
wym...@voicenet.com wrote:
>PSA, of course, means prostate specific antigen. It is a subsatance
>produced only by the prostate gland. It is produced by both normal and
>carcinogenic tissue. Normal tissue produces 0.5ng/ml per 1cc of
>tissue. Carcinoma produces 2.0ng/ml per 1cc.Thus the problem is to
>determine if an elevation is caused by enlargement of the prostate or
>cancer.
+++++++++++++++++++++++++++++++++++++++>
Wymet,
Good post. Very informative and to the point.
When PSA was discovered, it was believed to be prostate
tissue-specific. The greatest concentration of PSA is from seminal
plasma ( 1 million mcg/L), but now we know that nipple aspirate fluid
from female breast also is very high in PSA content (5000 mcg/L).
Male blood serum PSA is typically 4.0 ng/ml or less. Unfortunately,
PSA is not totally prostate tissue-specific, but is still the best
marker for cancer we have.
Your assertion that normal prostate tissue secretes 0.5 ng/ml per cc
is way off. A normal prostate is about 20 to 25cc in volume. By your
calculation it would produce 10 to 12.5 ng/ml of PSA. This is for a
healthy prostate. We know this is not correct. As a matter of fact,
the actual mechanism on how PSA permeates into blood serum is still
not totally clear. One theory is that PSA itself breaks down the base
membrane proteins and along with urokinase initiates the metastatic
cascade. The amount of PSA secreted by normal tissue used in the
medical literature varies. The most common one is 0.12ng/ml of tissue.
The volume of the prostate is calculated from ultrasonographic
measurements and are not very accurate, but still better than nothing.
Gland volume is calculated as follows:
V = width x heigth x lenght x 0.5 (for a prolate ellipsoid)
For a gland 4cm wide by 4cm high and 3cm long the volume would be:
V = 4 x 4 x 3 x 0.5 = 24 cc
Typically this gland would produce a PSA of 24 x 0.12 = 2.9 ng/ml
Let's assume this man had a baseline PSA of 10 ng/ml, then to
calculate the tumor volume the calculation goes as follows:
10 - 2.9 = 7.1 ng/ml and assuming that prostate cancer tumor secretes
PSA at a rate of 2.0 ng/ml then:
7.1/2.0 = 3.6 cc tumor is present
This is a rough calculation, but serves the purpose to do tumor
volume doubling time based on PSA velocity and doubling times.
It helps in making treatment decisions.
+++++++++++++++++++++++++++++++++++++++++++++>
The 10% are diagnosed with what is considered clinically significant
cancer, which has high potential for causing symptoms. This is the
portion of men that we need to identify early and separate by tumor
grade (aggressiveness), life expectancy, baseline PSA and free PSA
ratio. These tools should provide men with a base for treatment/no
treatment decision and if applied accross the board will reduce the
mortality rate from prostate cancer.
>Disclaimer - I am not a doctor but have spent a lot of time on the web
>and in medical libaries since first visiting a urologist
+++++++++++++++++++++++++++++++++++++++++++>
I am a prostate cancer survivor myself.
http://www.prostatecancer.com/
Regards,
Ralph