I would venture to guess that of the 800 or so who have come here during my
tenure, one or two

Furthermore, I wonder why my VA doctor ignored my PSA*V* as in
successive PSA checks it ran 1.27, 1.73 (to PSA = 3.9), 2.12, and
finally 2.31 (to PSA = 8.8). The dimwit let my odds of drying OF
prostate cancer increase by way more than tenfold AND let it invade my
seminal vesicle AND it may have even increased in Gleason grade before
he suggested I might look into it. If that weere in 2007 rather than
2004 I'd be filing formal charges of incompetence against him rather
then just a complaint. He and the rest of the VA doctors in that clinic
are equally uninformed and refuse to look at peer-reviewed proof I offer
them in other health issues. Two of them, for example, have demanded I
shed every ounce of fat in my body (which would be fatal), yet are
unconcerned about my newly pre-diabetic level of blood glucose.

Pick your physicians carefully, folks. There are a lot of idiots out
there wearing the caduceus and a stethoscope.

I.P.

Safire wrote:

......who write:

"A low PSA number doesn't mean you don't have PCa, just as a
high PSA does not mean that you do have PCa."
"Even if you do have cancer, you may, for the time being, want
to forego treatment (generally prostatectomy or radiation)
given the unfavorable side effects.  It all depends on your
age, the nature and scope of the cancer (staging and gleason
score). Your <sic> should not base your choice of treatment,
if any, only on the advice of the urologist."

Yep, pity the poor doctor who has to deal with numbnutz such
as that dumb web practitioner who can't spell or use proper
English grammnar.

___ Blue Wave/QWK v2.12

I knew about PSAV because I did some research when my PSA first went
from about the range 2.0--2.5 to 3.3.  My PCP and I kept tracking it,
and when it went to 4.5, he suggested retesting in two months.  At that
point I didn't want to wait, so he referred me to a urologist.  The
retesting resulted in 3.8, and I think he probably would have waited for
yet another increase had I not been concerned.

My source of information was one of the original research papers which
gave 0.75 ng/ml per year over a two year period as the cutoff point.  I
did some curve matching to determine what my PSAV was and came up with a
number slightly less than that.   (I believe the cutoff point has
subsequently been lowered.)   My urologist examined the data and
considered me borderline.  He suggested I could wait for another PSA or
I could go ahead then, since, as he described it, the procedure was safe
and not particularly painful.   He recommended the latter alternative
because he thought it would reassure me, so I think he was expecting it
to be negative.  My PCP was still in favor of waiting, but I went ahead
with the biopsy, and it showed a Gleason 7=3+4 cancer.   I think it is
quite possible that had I waited another year, my PSAV would have
approached or exceeded the 2.0 ng/ml increase in that year.

On the other hand, I am hardly typical.  PSAV is what we mathematicians
call a derivative, and I've spent many years teaching freshman about
derivatives.