Categorized | Feature, Prostate Health

The Importance of Knowing Your Baseline PSA For Prostate Health

If you have been recently diagnosed with prostate cancer, then your urologist most likely provided you with a PSA score. The PSA baseline score is your prostate specific antigen at the time of your first measurement of the antigen. This baseline is important because subsequent PSA values that are higher than the baseline may indicate a disease of the prostate, such as prostate cancer or benign prostatic hyperplasia. Further, your oncologist or urologist may consider your PSA before treatment has been administered.

One of the first questions patients who have been diagnosed, or re-diagnosed, with metastatic prostate cancer ask is, “How long do I have to live?” The answer to this question has changed over the years. While in the 1980s and early 1990s men were given an estimated 18 to 36 months from the time of diagnosis to live, the current understanding and estimation of survival is 5 to 6 years, maybe longer. The difference in survival rates is, in part, due to treatments; however, the major factor is the inclusion of PSA scores, velocity numbers, etc. These numbers allow researchers to form a clearer picture of the individual cancer and a closer estimation of survival.

And for those who have already been diagnosed with prostate cancer and have been treated, recurrence is a reality. According to the Prostate Cancer Foundation, out of those who have undergone treatment for prostate cancer, 20-30% will relapse after the five-year mark and begin to show signs of disease recurrence.
But survival for recurrence has also been extended. Many men in the United States are actually diagnosed at an earlier stage of the disease because of wide-spread PSA testing. Further, we now have a better understanding of cancer therapies, including hormone manipulation and taxane chemotherapy.

According to Duke University Medical Center researchers, men with a baseline PSA value of 10 or higher are up to 11 times more likely to die from prostate cancer than are men with lower initial values. In the study conducted by Duke University, 4,568 men over the past 20 years who have had PSA tests and were eventually diagnosed with prostate cancer were followed. With age and race taken into account, the risk of death from prostate cancer was calculated.

The study released showed a median age for their study as 65 years. The median baseline PSA was 4.5. Nearly 3.5% of the men died from prostate cancer during the study period, while more than 20 percent died from other causes. The analysis showed that men with a baseline PSA of less than 4 had a very low risk of death from prostate cancer, but those with 4 to 9.9 baselines were three times more likely to die from prostate cancer. And men with a baseline PSA value of greater than 10 were 11 times more likely to die than were men with PSAs under 2.5.

Given these results, it is evident that early diagnosis of prostate cancer, when the baseline PSA is lower, will decrease the mortality rate from prostate cancer. With PSA screenings and digital rectal exams, men may be saved from early, unnecessary death.

Baseline PSA scores are important in determining predicted survival rates for men who have been diagnosed with prostate cancer. Ping Tang, MD, a member of the Duke Prostate Center and the department of urology at Guangzhou First Municipal People’s Hospital, Guangdong, China comments, “It’s commonly held that men over the age of 75 don’t need to bother with PSA screening any longer, but [this study] tells us that chronological age alone may not be enough. Patients need to take into account their initial baseline value, and if it’s over 4, continuous screening may be beneficial.”

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April 2012
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