PSA velocity

How useful is it?

PSA velocity (PSAV) is simply a measure of how fast a man's PSA score rises from one test to the next over a period of time.

It is not a separate blood test that a man needs to have.

It is used as a tool to help determine a man's risk of having a positive biopsy for prostate cancer if he has a “normal” value.

It is also used to help doctors predict how aggressive prostate cancer may be.  

How it's measured

Generally doctors look at the results of three PSA tests over a period of two years.

The threshold value is dependent on the total PSA. The threshold is:

  • 0.35 ng/ml/year for PSA values < 4 ng/ml
  • 0.75 ng/ml/year for patients with total PSA values >4 ng/ml

What's an acceptable rise?

The "acceptable" rise in the score depends on what the initial score is.

For example, if your loved one's initial score is less than 4 ng/mL, a rise of 0.35 ng/mL per year or higher may be cause for concern.

So if your man's initial PSA score was 2.4 and it rises to 2.8 within 2 years, his doctor might suggest a biopsy.

If your man's initial score is between 4 and 10 ng/mL, his doctor might advise a biopsy if his PSA rises faster than 0.75 ng/mL a year.

For example, if his score went from 4 to 4.8 to 5.6 within 2 years.

Some controversy

Some physicians question the value of PSAV in assessing a man's risk of getting prostate cancer or determining how aggressive it may be.

And not all physicians believe in using PSAV to determine whether a man should have a biopsy. 

In fact, one study suggests that using PSAV will lead to an increase in unnecessary biopsies.

PSAV after prostate cancer treatment

PSA velocity is sometimes used for men who have already had treatment for prostate cancer.

For example, let's say your man has had a radical prostatectomy and his PSA starts to rise after his surgery.  His doctor may use PSA velocity to determine if he should have salvage treatment right away for his recurrence, such as:

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References:

American Urological Association. Prostate cancer: screening and management. http://www.auanet.org/education/prostate-cancer-psa.cfm.  Accessed March 26, 2105.

The American Cancer Society. Prostate Cancer. http://www.cancer.org. Accessed March 17, 2015.

American Urological Association. Prostate-specific antigen: best practice statement: 2009 update. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf. Accessed August 4, 2009.

American Cancer Society. Can prostate cancer be found early? http://www.cancer.org/docroot/cri/content
/cri_2_4_3x_can_prostate_cancer_be_found_early_36.asp. Accessed August 4, 2009.

Always consult a medical professional.

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