My very good Total PSA (prostate-specific antigen) test results on 2011-06-08

My Total PSA (prostate-specific antigen ) test results from my health screening on 2011-06-08, Wednesday is as follows.

Total PSA = 0.417 (Ref. Range: < 4.000 ug/L)

My PSA result is very good! This is probably due to my mainly simple plant-based diet.

If you have any comments or advice, please let me know.

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The following info is from:

http://www.health.gov.on.ca/english/providers/pub/cancer/psa/psa_guide/qa.html

What is PSA?

An abnormal PSA result has often been defined as > 4.0 ug/L and is frequently used as a cut-point in the prostate cancer literature.

Generally, experts do not recommend biopsying men younger than 60 years of age whose PSA levels are <4.0 ug/L, unless there is a concomitant abnormal DRE.

However, more than 20% of men with diagnosed prostate cancer have PSA levels lower than this.

Research has shown that prostate cancer can be detected within 3-5 years in 13%-20% of men whose PSA levels are between 2.6 and 4.0 ug/L.

Importantly, about 30% of men with PSA levels between 4.0-10.0 ug/L have cancers that have extruded beyond the prostatic capsule at the time of diagnosis with concomitant poorer prognosis.

A strategy for reducing unnecessary biopsies may be to measure free-to-total PSA levels, enhancing specificity.

In one study, Catalona and colleagues looked at the prevalence and clinicopathological features of prostate cancer in men with PSA levels of 2.6-4.0 ug/L and benign DRE to see if measuring the percentage of free PSA could reduce the number of additional biopsies needed.

Of 14,193 men who had PSA and DRE, 914 volunteers aged 50 and over had PSA levels of 2.6-4.0 ug/L with BPH and no prior suspicious screening tests.

Of these, 332 (36%) underwent ultrasound-guided-sextant needle biopsy. Cancer was detected in 73 (22%). Fifty-two of these cases were surgically staged; of these, 42 (81%) were organ-confined.
Ten per cent had clinically low-volume or low-grade tumours; and 17% were low-volume or low-moderate grade (possibly harmless).

Using a free PSA cut-off of <= 27% as the criterion for doing biopsy would have detected 90% of cancers, avoided 18% of benign biopsies (false positives), and produced a positive predictive value of 24% in men who had a biopsy performed.

By reducing the lower PSA cut-off, it may be possible to reduce the number of additional biopsies required.