PSA Velocity Matters

NEWS & NOTES
November 14, 2006

PSA velocity matters
The speed at which a marker for prostate cancer grows is a strong
indicator of how much risk a patient runs, even if the level is so low
that a biopsy ordinarily would not be ordered, researchers have written
in the Journal of the National Cancer Institute.

The findings suggest that doctors reconsider when and how often they
test men for the marker, PSA, or prostate-specific antigen.

First there is a question about what PSA level should lead doctors to
perform a biopsy. And even then things remain murky. If the biopsy is
positive, the patient is likely to undergo treatment, often with
serious side effects, even though the cancer may be so slow growing
that it never poses a threat.

The researchers based their findings on a review of blood samples
dating to 1958. They found that a better predictor of which men died
from prostate cancer was not the level of PSA but rather the PSA
velocity. Those men with the fastest-rising levels were most likely to
have died of the disease 20 to 30 years later.


Drug chats go quickly
Doctors reported discussing the cost of drugs only about a third of the
time, researchers say in The American Journal of Managed Care. Doctors
also failed to discuss important issues such as getting refills,
options for generics and insurance coverage.

"These can be important barriers to patient medication adherence,"
said Dr. Derjung Tarn of the University of California Los Angeles.
Tarn's team looked at patient and doctor surveys and transcripts of 185
audiotaped patient visits at two health care systems in California in
1999. In only 33 percent of the cases did the doctors talk about cost,
insurance, generic or brand name, logistics, supply or refills.
Patients asked about costs or insurance in only 2 percent of the cases.


Most of the patients had health insurance, and more than three-fourths
paid less than half of their prescription costs out-of-pocket.


Birthmarks finding
The best time to treat the type of birthmarks called port wine stains
may be well before children are even aware they have them, a study
suggests. Port wine stains are thin and flat in babies, but in
two-thirds of children the birthmarks will eventually thicken and
develop bleeding growths, making them more disfiguring and tougher to
treat, Dr. Anne Chapas of the Laser & Skin Surgery Center of New York
told Reuters Health.