Thank you for the link. I'm always interested in learning more.
I found the "take-home messages" from this report enlightening. The "messages" were directed to clinical urologists, but men like us who are interested in providing feedback to others would do well to take heed. The nine "messages" there bear repeating here:
(1) High PSA velocity is not an indication for biopsy;
(2) for men with a low total PSA but a high PSA velocity, consideration should be given to having PSA taken at a shorter interval;
(3) men with an indication for biopsy should be biopsied irrespective of PSA velocity;
(4) changes in PSA after negative biopsy findings do not determine the need for repeat biopsy;
(5) monitoring PSA over time can aid judgment in decisions about biopsy, as informed by the clinical context;
(6) PSA velocity is uninformative of risk at diagnosis;
(7) high PSA velocity is not an indication for treatment in men on active surveillance;
(8) PSA velocity at the time of recurrence should be entered into prediction models (or “nomograms”) to aid patient counseling;
(9) PSA changes after treatment for advanced disease can help indicate therapeutic response.
Important to repeat and note (6) that PSA velocity is uninformative of risk at diagnosis. If the PSA of an untreated man shoots through the roof (looks like a hockey stick on a PSA chart), then he likely has other non-cancerous contributors like prostate infection, or maybe BPH.
PSA density, on the other hand, can be correlated to PC aggressiveness at diagnosis. http://www.ncbi.nlm.nih.gov/pubmed/17222621