Editorial Comment

Abstract

This commentary represents the author's opinions on prostate-specific antigen (PSA) kinetics and does not reflect the views of any professional organization or consensus panel. Indeed, their views conflict with actual guidelines from several major international organizations. For example, the 2012 National Comprehensive Cancer Network Guidelines recommend considering prostate biopsy for a suspicious digital rectal examination, PSA >2.5 ng/mL, or PSA velocity ≥0.35 ng/mL/year. 1 National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology: Prostate cancer Early Detection. Available at: http://www.nccn.org/professionals/physician_gls/pdf/prostate_detection.pdf. Accessed June 12, 2012. Google Scholar Other international groups such as the Australian Cancer Network and European Society for multivariable approach for biopsy decisions along with other factors such as age, digital rectal examination, and prostate size as part of a multivariable approach for biopsy decisions. 2 Horwich A. Parker C. Bangma C. et al. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010; 21: v129-v133 Crossref PubMed Scopus (79) Google Scholar , 3 Cancer Council Australia. Available at: www.cancer.org.au. Accessed April 20, 2013. Google Scholar A Commentary on PSA Velocity and Doubling Time for Clinical Decisions in Prostate CancerUrologyVol. 83Issue 3PreviewAlthough the value of prostate-specific antigen (PSA) velocity or doubling time has never been seriously questioned for aiding the clinical management of recurrent or advanced cancer, there has historically been considerable uncertainty about PSA kinetics for decisions about biopsy and initial treatment. Recent studies, including analyses of cohorts from all the major randomized trials of localized prostate cancer, have failed to find any evidence that PSA velocity and application of PSA cutpoints are of benefit in this setting. Full-Text PDF ReplyUrologyVol. 83Issue 3PreviewThe commentary starts by suggesting that our article contradicts major professional guidelines. It omits to mention that the NCCN recommendation is flagged as involving “major NCCN disagreement that the intervention is appropriate”. The guideline from the European Society for Medical Oncology is out of date; the most recent guideline1 does not include prostate-specific antigen (PSA) velocity in localized disease. The third reference given is a website of an educational nonprofit, in which the only reference to PSA velocity is a patient guide from 2010. Full-Text PDF