From the Research
Generally, PSA increases should be minimal, with most experts considering an annual rise of less than 0.75 ng/mL as acceptable at age 66. However, what's most important is the overall pattern and velocity of change rather than a single year's increase. If your PSA rises by more than 0.75 ng/mL per year, or if you experience a sudden significant jump, you should consult your doctor promptly as this could warrant further investigation. Regular annual PSA testing is recommended for men your age, especially if you have risk factors for prostate cancer. Remember that PSA levels can be affected by many factors besides cancer, including benign prostate enlargement, inflammation, recent ejaculation, or certain medications like finasteride or dutasteride. Your doctor will interpret your PSA results in the context of your overall health history, previous PSA values, and possibly other markers to determine if additional testing like a prostate biopsy is necessary 1.
Key Considerations
- The decision to employ a conservative approach, such as active surveillance or watchful waiting, is determined by both patient and disease factors 1.
- Conservative management strategies play a vital role in the management of prostate cancer, demonstrating similar long-term oncological outcomes to radical treatment while reducing harm from overtreatment and maintaining quality of life 1.
- Factors such as PSA doubling time and volume progression are important triggers for intervention in patients undergoing watchful waiting or active surveillance 2.
Monitoring and Follow-Up
- Regular monitoring with PSA testing and digital rectal examination (DRE) is essential for patients undergoing watchful waiting or active surveillance 2.
- Re-biopsies may be necessary to assess for grade progression or volume progression in patients with localized prostate cancer 2.
Impact of Medications
- Certain medications, such as finasteride, can lower total and free PSA levels, which should be taken into account when interpreting PSA results 3.
- The effect of medications on PSA levels should be considered when evaluating the risk of prostate cancer and determining the need for further testing or intervention 3.