And now for a brief PSA.

June 8, 2017. Prostate-specific antigen (PSA) doubling time, time to PSA failure, PSA nadir. We've heard them all, but how do you make sense of them? Especially when counselling anxious men whose post-radiation PSA changes like ocean sea levels (looking at you, Al Gore). In a secondary analysis of the D'Amico trial of radiation +/- 6 months androgen deprivation therapy for intermediate risk prostate cancer, PSA failure was useless for predicting death. However, failure within 30 months, PSA doubling time < 9 months, and especially nadir > 0.5 did predict death. If you see these, get serious. Oh yeah, and melting permafrost is threatening the world seed bank (that's for you, Al).

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