I'm going with Catalona's protocol of 2.5. So anything over that I'll
be getting a biopsy.

Response from harold...

Dr. Stephen Strum, who along with Donna Pogliano wrote what some folks
may consider the "Bible" on PCa titled (A Primer on Prostate Cancer".
I quote as follows from the book:

If the rate of doubling of PSA (PSA doubling time or PSADT) or the rate
of increase in PSA (PSA velocity or PSAV) is abnormal, then PC is more
likely (the book has more likely in italics) present than not.

The book then follows with this statement which was printed in RED in
the book:

A PSADT shorter than twelve years and a PSA velocity greater than0.75
ng/ml/year (nonograms per milliliter per year) relates to a greater
probability of a malignant condition.

The book also states these are adjunctive tests, and although they are
not absolute criteria for or against malignacy, they are valuable
tools.

Dick, as to whether a biopsy is warranted if your PSAV OR PSADT is
abnormal, I will leave that decision to you and your doctor who,
hopefully, is someone with broad and current knowledge of PCa and who
is treating men with PCa.  From my own experience I think it is fair to
say that just because a physician in a internist or urologist that does
not deem them competent in diagnosing and treating PCa.

Be vigilant in keeping yourself up to date, find a physician with
experience in treating PCa then be your own strong advocate.  Ask
questions, seek answers and if you are not comfortable that your
physician is forthcoming then fire him / her and find someone else.  I
say that with the wisdom of hindsight.

Response from Harold

Dick, unfortuntely at a time that my father was dealing with his PCa
the disease was not a subject of widespread conversation.  He said
little about it, I was younger then and asked little about it so my
knowledge of his PCa is quite limited.  His physician has retired from
practice and my attempt to get hold of his PCa medical record was not
successful.

I am not making that mistake with my son who is one year younger than
you are.  I keep him up to date on my situation and he is aware that he
is in a higher risk category.

Finally, even though you at a higher risk for PCa , it should not be a
foregone conclusion you will develop PCa.  The odds favor the fact that
most men will not have PCa that threaten their lives.  PCa should be a
concern to you but not overwhelmingly so.  Be vigilant but for sure go
about your life knowing that you more likely won't than will develop
PCa.

You may also want to update your knowledge on lifestyle issues,
nutrition and supplements that may - may - help to reduce the chance of
acquiring PCa.  There is not a lot of absolute "for sures" on this
subject but is there some indications there are things you can do in
your quest to avoid PCa.

Also you are young and it is the hope, I think, of all men with PCa
that within the next few years early diagnosis will be enhanced,
treatment regimens improved and, of course, the ultimate hope is for a
cure.

One final thing...if you are married be sure your wife is kept in the
loop so she acts as your partner and friend with your knowledge, your
concerns and your activities related to this subject.  My wife goes
with me to my physician visits so she can hear my questions and his
answers.  She has actually sat in the examining room whilst my doc was
doing the infamous DRE so she understands that procedure.  As I was
bent over I just looked at her, smiled, winked and she smiled and
shrugged her shoulders  - sort of an "oh well" gesture.  Not a great
scene but just wanted to emphasize that I think it important that as
you move forward keep your wife involved although I'm not sure I would
recommend that with a girlfriend.

All the best,

Harold

There is a gene which makes the likelihood of breast cancer very high.
Women who have this gene may have prophylactic surgery to remove their
breasts in some cases.   As far as I know, no one has isolated a
corresponding gene for prostate cancer.