Guest guest Posted October 15, 2011 Report Share Posted October 15, 2011 Agreed. I had a PCA3 test of 86.7 and clear biopsies afterward. Keep in mind that PCA3 is expressed in PIN tissue; this tissue is commonly called precancerous tissue but the lead time can be very long. In addition, identifying normal, PIN, and cancer is a continuous scale of gradation in biopsy tissue. Anyway, the PCA3 test alone has been pretty well discredited. Also, every biopsy carries its own risk which is not inconsequential. Furthermore, repeat biopsies are proven to have negative effects in the same risk areas as prostate removal surgery though at a lower overall probability level. Rich L > > As we all know, PSA scores are hard to interpret, partly because they can > vary widely over a short period of time. In that regard, the PCA3 test is > supposed to be an improvement, a more " stable " score, if you like. After > getting PSA scores of 5.6 and 4.9, eight days apart last January, my > urologist recommended that I get a PCA3 test, which I did. My PCA3 score was > 16.6, which is " good " (note that PCA3 scores aren't on the same scale as PSA > scores), so my urologist was very encouraged. But another PSA test in May > showed a score of 9.5, so I had a biopsy, which revealed Gleason 7's. So, > for me, the PCA3 test was useless. Perhaps it works well in other > circumstances, and I don't mean to suggest that it's never worth trying. The > struggle for better testing goes on. > > --Phil > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 15, 2011 Report Share Posted October 15, 2011 Over the past decade there has been an increase in a significant trend that recommends cautious optimism in responding to news releases about new treatments and biomarkers. A strong motive for academic researchers (and their instiutions) is to have their discoveries patented and purchased at very high prices by the pharm industry. Thus patients should take a firm 'wait and see' approach to such news releases. A case in point is the early papers on the blood biomarker EPCA2 three to four years ago. They indicated a very accurate and specific response to prostate cancer. However, the research has not been able to be replicated and the pharma company that supported the research at the Univ. of Pitsburg ended up suing Pit and the researcher for fraud. Having had my hopes for a better biomarker raised and then shot down by the EPCA2 story, I had hope again for the PCA3 urine test, which I am using as part of my Active Surveillance protocol. A PCA3 score of 35 is suggested as the cutoff for suggesting a biopsy. Some studies have suggested that high levels of PCA3 indicate a higher Gleason score, larger tumors, and a more aggressive cancer. However, just as many studies show no correlation between PCA3 and Gleason, tumor size, or aggression. The more PCA3 studies are published, the more it appears that factors affecting the PCA3 score are highly variable from man to man. For example, one study of 351 men, for 202 men with a negative biopsy (no cancer found) PCA3 scores ranged from 1 to as high as 2,827 (mean 49, median 18) and PSA from .14 to 63 (mean 7.8, median 5.9). 134 men with a positive biopsy (cancer found) had PCA3 scores from 0.1 to 1,355 (mean 94, median 25) and PSAs from 0.14 to 1,619 (mean 15.6, medan 7.0). So, on the average, men with cancer had higher PCA3 scores than men with no cancer found, but, for some men with no cancer their PCA3 score could be very much higher than the suggested cutoff of 35. With respect to PCA3 suggesting a more aggressive cancer, two studies that found a correlation betweeen PCA3 and aggressive characteristics suggested a cutoff of 35 for suggesting aggresive cancer, but, this is the same level used for suggesting any cancer, not just aggressive cancer. My take is that in terms of suggesting the need for a biopsy, the PCA3 urine test is somewhat more specific than PSA, but not much more accurate. The best use of PCA3 for monitoring in Active Surveillance appears to be the same as for PSA- establish a record of your specific scores and look for trends over time. As for the new combinaton test announced by the U. of Michigan, let's wait and see. The Best to You and Yours! Jon in Nevada > > All men contemplating their first biopsy based on the simple PSA test, should > get this test prior to the biopsy. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 15, 2011 Report Share Posted October 15, 2011 > This urine test is interesting my question is, the article > concentrates on screening prior to biopsy what about monitoring > prostate after treatment? I am two and a half years post > surgery, radiation, and ADT I ceased ADT a year and a half ago. > My follow up PSA's have been less than .008 But one can't help > but wonder how accurate that is. I did have capsular > penetration and a Gleason score of 9. Harry, I think you are doing extremely well. As far as I know, everyone who has a recurrence of cancer after treatment will see it as a rising PSA. I doubt if any other testing is needed. However, the next time that you get a PSA test you might ask to have your testosterone level checked at the same time. In some men, testosterone rises very quickly after discontinuing ADT. In others it does not. If your testosterone level is still way below normal then it is conceivable that you still have some ADT effects that are a factor in your extremely low PSA score. Assuming that you do not have an ADT level of testosterone, then your low PSA score is a terrific sign. From what I've read, most men who go below 0.4 will not have a recurrence, and if they go below 0.2 they're very unlikely to have a recurrence. Your 0.008 is waaaay below that. In the meantime there's really nothing you should be doing about your PCa except staying healthy with good diet and exercise and enjoying life. After all, that's what treatment is for. It's not to save us from death so that we can spend our time worrying, it's so we can enjoy life for some more years. Anyway, that's how I see it. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 15, 2011 Report Share Posted October 15, 2011 Hello Gang: I go to my PCP Tuesday to check and see what is going on with my Urethra. I went through a series of antibiotics and 14 pills seemed to have cleared the urgency, and the pain when I went to the bathroom. One week later it started again with the pain,burning, and urgency. I have to see my PCP before more treatment. Question? Since the pain went away after about seven hours. and it seems Ok now could it have been fragments from kidney stones? Mr. Maack knows I return to my Urologist on Nov. 3rd to get my PSA checked, and see what my options are. For those that don't know after my operation my PSA was 3.7. I asked my Urologist Why? His response was "That's a good question". Has the cancer cells left behind has anything to do with my recent episode of burning pain, urgency every five minutes or so. If I have no prostate gland what can they radiate? I know I have no feeling in the area; sex bundle numb, or if I have one at all. Can you give me some idea what will probably be my next obstacle. Thanks Rody Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 16, 2011 Report Share Posted October 16, 2011 Alan Thank you for the positive reply; I will request a testosterone level. My last four PSA's have been unchanged at <.008 so that is encouraging. I have noticed a few changes such as regrowth of under arm hair which is a secondary sexual charteristic so hopefully my testerone level will be near normal. I believe that the moves against PSA testing are a huge impediment to prostate cancer treatment and should be vigorously opposed. Harry To: ProstateCancerSupport Sent: Saturday, October 15, 2011 12:53 PMSubject: Re: New test > This urine test is interesting my question is, the article> concentrates on screening prior to biopsy what about monitoring> prostate after treatment? I am two and a half years post> surgery, radiation, and ADT I ceased ADT a year and a half ago.> My follow up PSA's have been less than .008 But one can't help> but wonder how accurate that is. I did have capsular> penetration and a Gleason score of 9.Harry,I think you are doing extremely well. As far as I know, everyone who has a recurrence of cancer after treatment will see it as arising PSA. I doubt if any other testing is needed.However, the next time that you get a PSA test you might ask tohave your testosterone level checked at the same time. In somemen, testosterone rises very quickly after discontinuing ADT. Inothers it does not. If your testosterone level is still waybelow normal then it is conceivable that you still have some ADTeffects that are a factor in your extremely low PSA score.Assuming that you do not have an ADT level of testosterone, thenyour low PSA score is a terrific sign. From what I've read, mostmen who go below 0.4 will not have a recurrence, and if they gobelow 0.2 they're very unlikely to have a recurrence. Your 0.008is waaaay below that.In the meantime there's really nothing you should be doing aboutyour PCa except staying healthy with good diet and exercise andenjoying life. After all, that's what treatment is for. It'snot to save us from death so that we can spend our time worrying,it's so we can enjoy life for some more years.Anyway, that's how I see it.Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2011 Report Share Posted October 17, 2011 > Assuming that you do not have an ADT level of testosterone, > then your low PSA score is a terrific sign. From what I've > read, most men who go below 0.4 will not have a recurrence, and > if they go below 0.2 they're very unlikely to have a > recurrence. Your 0.008 is waaaay below that. When I wrote that I was thinking about Harry's radiation and ADT treatment and wasn't paying attention to the fact that Harry also had surgery. What I said should only be appllied to patients who still have prostates and were treated only with radiation and, possibly, ADT. Chuck has pointed out to me that post-surgery patients should have a PSA below .03, which is a level that can be accounted for by non-cancerous PSA sources outside the prostate. Harry, Sorry about the confusion on my part. I think what I said about your 0.008 being an excellent PSA reading is still right, and my suggestion to have your testosterone checked along with your next PSA test is still good. I hope it stays that low forever. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2011 Report Share Posted October 17, 2011 Hi, Alan,What are these 'non-cancerous PSA sources outside the prostate, please?Thanks!MikeSent from my iPad > Assuming that you do not have an ADT level of testosterone, > then your low PSA score is a terrific sign. From what I've > read, most men who go below 0.4 will not have a recurrence, and > if they go below 0.2 they're very unlikely to have a > recurrence. Your 0.008 is waaaay below that. When I wrote that I was thinking about Harry's radiation and ADT treatment and wasn't paying attention to the fact that Harry also had surgery. What I said should only be appllied to patients who still have prostates and were treated only with radiation and, possibly, ADT. Chuck has pointed out to me that post-surgery patients should have a PSA below .03, which is a level that can be accounted for by non-cancerous PSA sources outside the prostate. Harry, Sorry about the confusion on my part. I think what I said about your 0.008 being an excellent PSA reading is still right, and my suggestion to have your testosterone checked along with your next PSA test is still good. I hope it stays that low forever. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 17, 2011 Report Share Posted October 17, 2011 I'm having trouble finding a reference at the moment, but if I remember correctly there are several possible sources of PSA. The most important one, not counting the prostate, is the adrenal gland. Alan > Hi, Alan, > What are these 'non-cancerous PSA sources outside > the prostate, please? > Thanks! > Mike >> Chuck has pointed out to me that post-surgery patients should >> have a PSA below .03, which is a level that can be accounted for >> by non-cancerous PSA sources outside the prostate. Quote Link to comment Share on other sites More sharing options...
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