As a former hospital laboratory director and prostate cancer survivor I noticed one glaring omission in this article regarding prostate cancer. The omission is how to monitor prostate cancer progression. Unfortunately, the primary current measurement is the PSA. PSA does not distinguish between rapid or slow growing prostate cancer. Also, in spite of what your doctor might say, there is no normal PSA level. Thus, men must monitor their PSA by annual testing. What is important is the rate of change in the PSA level from year to year, the PSA velocity. If a rapid rate of change or especially a doubling of PSA in a year is evident, then further testing is warranted beit quarterly PSA testing, biopsy, MRI, etc. Case is point is an acquaintance of mine whose PSA went from a PSA of 1.0 to a PSA of 2.0 in a year. He was under the impression his PSA was still normal. I told him he needed to seek further testing immediately. He was a Gleason (3+4)=7 with an agressive cancer. Additionally, avoid sex, exercise, etc. at least 3 days before PSA testing, and have the test performed at the same laboratory each time for consistency.
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