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hyperplasia (BPH) and prostatitis can also elevate PSA levels. It is estimated that 70% to 80% ofmen with an elevated PSA who have a biopsy do not have cancer (Loughlin, 2011).Approximately 20% of men who have cancer other than in the prostate also have a normal PSA(< 4 ng/ml), giving some men a false sense of security (Loughlin, 2011). Clinicians must take a man’s age into account when considering a PSA level. PSA velocity was developed by cliniciansand is used to observe how a man’s PSA level changes over time, rather than using it as a one-time indicator (Loughlin, 2011). PSA scores have proven to rise more rapidly in men with prostate cancer than in those with BPH.Issues with Sensitivity, Reliability, and Predictive valuesPSA has offered some diagnostic advantages when levels were above 10 ng/mL, however, efforts have continued to detect cancer at lower PSA levels (Loughlin, 2011).Detection at lower PSA levels would lead to higher survival in prostate cancer sufferers. Severalattempts have been made to increase the sensitivity of the PSA as a marker for detection of prostate cancer. These attempts have led to an introduction of refinements, some of them using derived values (PSA density and PSA velocity) (Loughlin, 2011). These refined tests have led toan increasing number of prostate cancer diagnosis and survivals from the disease.
6512_DB34ReferencesAmerican Cancer Society . (2018). Prostate cancer prevention and early detection. Retrieved from Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.Hammer, G. D., & McPhee, S. J. (2014). Pathophysiology of disease: An introduction to clinical medicine(7th ed.). China: McGraw Hill.Loughlin, K. R. (2011, March 16). Is psa reliable? Harvard Medical School + Harvard Health Publications: Prostate Knowledge . Retrieved from McCance , K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2014). Pathophysiology: The biologic basis for disease in adults and children(7th ed.). St. Louis, MS: Elsevier.