Chapter 2 – Prostate Cancer Screening Guidelines and Discussion of PSA (Prostate Specific Antigen) Density and Gleason Scoring System

Dr. David B. Samadi, Chief of Division of Robotics and Minimal Invasive Surgery for Mount Sinai School of Medicine, discusses prostate cancer screening guidelines, whereby it is recommended for men over the age of 50 to get screened. Men in high-risk groups such as African-American or those with a family history should get screen at age 45. He also discusses the Prostate Specific Antigen (PSA) definitions, which is a basic blood test. He also discusses the density, velocity and implications of PSA results. It is important to note the rate of rise of PSA over time. The PSA value is not as important as the velocity rate, which is why three measures are taken over an 18-month period. Dr. Samadi also discusses biopsies, being that there are no standardized systems, therefore the number of PSA cores can vary from specialist to specialist. He also discusses the Gleason Pathologic Scoring system and important of obtaining second opinions.

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