Based on PSA velocity over 18 weeks, which statement best describes the data?

• A. Patient A may have a more aggressive prostate cancer based on the velocity of these measurements.
• B. Patient A is most likely to have benign prostate cancer.
• C. Patient B is most likely to be experiencing an inflammatory reaction and this is largely contributing to the elevated PSA above 100 ng/mL.
• D. Patient B may have a more aggressive prostate cancer based on the velocity of these measurements.

Answer: (D)

PSA velocity—the rate at which PSA changes over time—tells you more about cancer behavior than a single PSA value. Over 18 weeks, if one patient shows a noticeably steeper rise in PSA than the other, that faster trajectory suggests a higher likelihood of aggressive prostate cancer in that patient. An inflammatory process can raise PSA, but it typically does not produce a sharp, sustained increase over several months in the same pattern as a rapidly growing cancer. So the data best support that the patient with the greater PSA velocity may have more aggressive disease.