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Old 11-25-2008, 06:06 AM   #1
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A man over 50 years what should the PSA reading be?

A man over 50 years what should the PSA reading be?

 
Old 11-28-2008, 06:49 PM   #2
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Re: A man over 50 years what should the PSA reading be?

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Originally Posted by Vchlim View Post
A man over 50 years what should the PSA reading be?
Here is what is known about the PSA level "for men without clinical evidence of prostate cancer, and I'll bet it will surprise you:

Age..........PSA (median, meaning average (half lower/half higher)

40s..........0.7

50s..........0.9

60s..........1.4

I have this information in the "Program" book from the IMPaCT Conference (Innovative Minds in Prostate Cancer Today), held in September 2007, page 40. The source is a table and statement by Dr. William Catalona, a famous prostate cancer and especially a PSA researcher and surgeon, now at Northwestern University in the Chicago, Illinois area. Dr. Catalona is more or less effectively the dean of American urologists.

Dr. Catalona goes on to state that "... If a man's PSA level is at the median value or less for his age group, then the risk for prostate cancer is very low. If a man's PSA is higher than the median for his age group, his risk of having prostate cancer is higher and the risk that the cancer is aggressive is higher...."

What struck me in the table was how low the median values are.

It seems to me the great benefit of the table and Dr. Catalona's statement is the assurance it gives for men whose PSAs fall below the median. Even though the risk is higher for men above the median, risk is still fairly low, and we would get an abundance of negative biopsies if all men above the median values were to have biopsies.

Based on his research, Dr. Catalona has been the moving force for lowering the PSA biopsy threshold to 2.5 instead of 4.0, after challenging with antibiotics and repeated PSA measurements to try to rule out prostatitis as a cause. Personally, I'm not impressed that that many extra cases of prostate cancer are found or that the earlier discovery gains much, but I'm a layman veteran of this disease and have no medical credentials. Looking at the numbers for results with a threshold of 2.5 versus 4.0, perhaps with age adjustments, the increase in detection is no more than a few percent.

Here are PSA levels that almost all men with healthy prostates will fall below. Naturally, these values are much higher than the median values. These are the values normally used by doctors as the PSA part of the evidence for deciding whether to recommend a biopsy. These are the values that most of us are familiar with, especially the general threshold of 4.0, which Dr. Catalona suggests be reduced to 2.5.

Age..........PSA..........African
.............Most Men...American

40s..........<=2.5.....<=2.0

50s..........<=3.5.....<=3.0

60s..........<=4.5.....<=4.0

70 & up....<=6.5.....<=6.0

The source is a book by Drs. Onik and Centeno, and I've seen those or similar numbers in other books.

I hope this helps.

Take care,

Jim

 
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