PCA3 - relatively new test for diagnosing Prostate cancer

[Guest guest]

I thought I'd share something with the group that has little to do with

testosterone but everything to do with our family jewels.

PCA3 is a relatively new test that is thought to be a better predictor of

prostate cancer than PSA. When I first heard of it very recently, I searched on

this forum for messages discussing it, but was unable to find any.

You may be aware that the PSA test has in recent years been criticized for not

being a very good diagnostic tool for determining the presence of prostate

cancer. High PSA results have been the cause of a lot of unnecessary biopsies

and unnecessary followup treatment. You can count me among those who have

undergone a biopsy with negative results, several years ago.

I have consistently had relatively high PSA results for years, nay decades. I

always see the doctors frown when they see the report.

I recently changed urologists (my guy who put me on Arimidex finally retired).

My PSA is now generally greater than 6. My new uro did a repeat test to confirm

this level. However, rather than send me for yet another biopsy, he had me come

in to do some ultrasound imaging of the prostate and to take a urine sample for

a PCA3 test.

In case anyone's curious, my uro's initial immediate feeling (without waiting

for the PCA3 results) was that he wasn't particularly concerned. The ultrasound

presented no suspicious-looking lesions, and he measured my prostate as about

the size of an orange when it should be the size of a walnut. He said that

enlarged (non-cancerous) prostates trigger high PSA results, and this looked

like the smoking gun. With a size in about the 99th percentile, it's a wonder

that my prostate hasn't caused urinary distress, but I understand it's less

important what the size is and more important how much of a stranglehold it has

on the urethra.

Anyway, continuing on to this new PCA3 test: You can Google " PCA3 " to get

whatever level of details you like, but my understanding is that it is based on

a genetic analysis of the cells that are shed into the urine immediately

following massage of the prostate gland during a digital rectal exam. It

correlates much, much more directly than PSA with the likelihood that a

follow-up biopsy would reveal cancerous tissues.

This is a relatively new test and is much better known in Europe than in the US.

I think the FDA has not yet gotten on board with it. My doctor says it's

expensive, few labs can handle it, and it's slow (I don't expect to hear the

results for another 3 weeks).

So, the moral of the story is that if you have a high PSA, don't be mislead into

assuming that you have a high risk of cancer. Have your doctor evaluate the

size of your prostate, and ask him/her about the advisability of running a PCA3

test.

Bob