Here is an article I don't understand. I would very much appreciate
anyones help in getting me to understand or your interpretation. I'll
mark what I don't understand with ">>>" symbols.

July 7, 2004 -- There's a new red flag for men facing prostate cancer
surgery: It's called PSA velocity. When PSA (prostate specific antigen)
level increases sharply in the months before surgery, the cancer is
likely to be aggressive.

Men with localized prostate cancer whose PSA increases sharply have a
higher risk of dying from their cancer -- whether they have surgery or
not, researchers say. Their study appears in this week's issue of The
New England Journal of Medicine. These men should be treated
aggressively and given priority for clinical trials to improve their
survival chances.

removed, how can it the prostate still have spread?

In his study, lead researcher Anthony V. D'Amico, MD, PhD, with Brigham
and Women's Hospital and Dana-Farber Cancer Institute, investigates PSA
velocity as an indicator of advanced tumors. The rate at which PSA
levels rise -- called PSA velocity -- prior to surgery seems to predict
the death from prostate cancer.

Men with high PSA velocity in the months before diagnosis were nearly
10 times more likely to die from prostate cancer within the next five
to seven years, he reports.

It brings up the issue of "watchful waiting," which has been debated
among prostate cancer specialists. Today, prostate cancer is typically
detected via PSA tests long before a tumor is evident.

Prostate cancer often grows so slowly that men will frequently die of
other causes, so doctors will monitor the cancer but patents won't
receive active treatment as long as symptoms do not occur or worsen.

"Watchful waiting is an option for managing localized prostate cancer
when both the patient and physician agree that the potential adverse
effects of treatment exceed the expected benefits," writes D'Amico.

But the rapidly growing body of information on PSA suggests that PSA
velocity "will become critical in predicting prostate cancer survival,"
writes Mario Eisenberger, MD, with Johns Hopkins Medical Institutions,
in an accompanying editorial.

The Details

The 1,095 men in D'Amico's study all had localized prostate cancer --
it had not spread beyond the prostate. During the year before
diagnosis, each had their PSA levels tested. Following diagnosis of
prostate cancer, each had radical prostate cancer surgery. Researchers
kept track of the men's progress for the next seven years.

Overall, there were 366 cancer recurrences and 84 deaths; 27 deaths
were from prostate cancer.

recurrence rate?

For men whose PSA velocity was 2.0 nanograms per milliliter per year or
higher, the risk of death from prostate cancer was nearly 10 times
higher compared with men whose PSA level increased more slowly.

The increased risk of death from prostate cancer in men with high PSA
velocities occurred despite the fact that these men underwent surgery.

Bottom line: Watchful waiting may be advised only for healthy men with
low PSA velocity.

D'Amico is recruiting men with high PSA velocity for a study comparing
results of prostate cancer surgery with an aggressive
radiation-chemotherapy treatment.