The quote from Dr. Catalona is as follows:
"In my PSA Study, the median PSA value for the age group of men without clinical evidence of prostate cancer is 0.7 for men in their 40s, 0.9 for men in their 50s and 1.4 for men 60 years of age or older."
The entire article is at this address:
Bill K. from NJ
Mostly Quotes below are from that article, but as far as I can tell he never defines "substantially":
Instead of the median quoted above, the author seems to be measuring substantially above the median
"If the PSA is at the median or less for the age group, then the risk for prostate cancer is very low. If a man’s PSA is higher than the median for his age group, his risk of having prostate cancer is higher and the risk that the cancer is aggressive is higher. The higher the PSA, the higher the risk for cancer and aggressive cancer.
If the PSA is substantially above the median
, I recommend a trial of antibiotics and repeat PSA measurements to see if the PSA comes down. If it doesn't, I recommend a biopsy.
In any case, I recommend an initial biopsy if the PSA is persistently higher than 2.5 ng/ml.
Several studies have shown that in men without clinical evidence of prostate cancer but most of whom have benign enlargement (called benign prostatic hyperplasia or BPH), the PSA level increases approximately 0.1 ng/ml/year.
If the total PSA is less than 4 ng/ml but the PSA velocity is greater than 0.3 ng/ml/year – verified with repeated measurements to rule out test variability– then I believe that rise in PSA calls for a biopsy."
If the PSA is higher than 4 ng/ml, a PSA velocity higher than 0.75 ng/ml/year should prompt a biopsy, even if a previous biopsy has been negative for cancer.
In all instances, rises in PSA should be treated with antibiotics and repeated PSA testing to rule out laboratory variation or prostatitis. Patients with dramatic increases in PSA are as likely to have inflammation in their prostate called prostatitis as prostate cancer."