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Sir,

PSA plays an important part and guides treatment decisions in patients with BPH or prostate cancer. Since its isolation by Wang et al.[1] it not only helps to indicate the need or not for prostatic biopsies, but is indispensable for monitoring the response to treatment of prostate cancer. The PSA assay helps in everyday clinical practice to determine the need for prostatic biopsies (first biopsy or repeated biopsies if PSA levels are increasing), the PSA nadir after radical treatment (surgical or radiotherapy), and the need to start treatment for recurrence with an increasing PSA level. There is thus a need for a simple graphical display of PSA levels over time to aid making these decisions. We have plotted graphs from PSA readings of patients in our urology clinics who have BPH or prostate cancer (new diagnosis and confirmed cases who have relapsed after treatment and need additional hormonal manipulation or other treatment). The advantages include ease of interpretation and retrieval, and less time wasted consulting the patient’s records. This can only lead to better patient care. We therefore advocate the use of PSAGraph and its incorporation into patient records, to enable clinicians caring for these patients to use an easily retrievable record that will aid patient management.

Fig. 1: PSAGraph of a patient who had three negative prostate biopsies and yet still had an abnormal PSA level on follow-up.

Fig. 2: PSAGraph of patient with prostate cancer while on hormonal treatment.