PCA3 results

[inspectormoe]

I have searched the threads for info on the PCA3 test but little has been mentioned. When my PSA made a leap from 3.4 to 4.8 in 6 mos. I started doing research wherein I discovered the PCA3 plus test. Fortunately I was able to get the test which came back with a number of 33.6. 35 is the cutoff number. I.e. the lower the number the lesser the chance of prostate cancer and over the 35 cut off it increases the risk. My 33.6 puts me at a 30% probability of prostate cancer. A recheck of the std PSA showed a drop to 4.0 but the PCA3 has me concerned.

I'm 59 so I'd like to make a good decision but my last biopsy was not a good experience. 25 samples and I bled for a week along with pain etc. I guess the biopsy is the way to go but the thought of a saturation biopsy scares the bajeezus out of me. What's anyones experience with the test?

Thanks

[IADT3since2000]

Originally Posted by inspectormoe

I have searched the threads for info on the PCA3 test but little has been mentioned. When my PSA made a leap from 3.4 to 4.8 in 6 mos. I started doing research wherein I discovered the PCA3 plus test. Fortunately I was able to get the test which came back with a number of 33.6. 35 is the cutoff number. I.e. the lower the number the lesser the chance of prostate cancer and over the 35 cut off it increases the risk. My 33.6 puts me at a 30% probability of prostate cancer. A recheck of the std PSA showed a drop to 4.0 but the PCA3 has me concerned.

I'm 59 so I'd like to make a good decision but my last biopsy was not a good experience. 25 samples and I bled for a week along with pain etc. I guess the biopsy is the way to go but the thought of a saturation biopsy scares the bajeezus out of me. What's anyones experience with the test?

Thanks

First, congrats on that falling PSA! That's particularly significant as the second test moves you out of the zone where your PSA velocity would be greater than 2.0 over a year's time, a situation found to involve extra risk in research led by Dr. Anthony D'Amico (and, conversly, lower risk if your increase is 2.0 or less, and the lower, the better).

Thanks for sharing your experience with the PCA3 test. From what I've read about it, it sounds like its result is an excellent piece of information to have, though in your case it did not exactly settle the issue. Would you mind sharing more of your experience with the test? Was your doctor already familiar with it and in favor of it; what was his view; or did you insist on it? What was the "attentive DRE" like? Did you get the results quickly? Was it covered by insurance? Do you know how much it cost? What lab ran the test? I've heard talks about it, but I yours is one of the few first hand accounts I've seen.

Thanks also for sharing your experience with a saturation biopsy, even if it was at the lower end of what is considered "saturation." Twenty five cores sounds like a lot to me! Dr. Gary Onik, MD, of Celebration, Florida, described saturation biopsies of 70 to over a hundred cores in a presentation at the International Conference on Prostate Cancer 2006, held in Reston, Virginia, and his talk is available on a DVD. I was impressed, but I wondered what the experience would be like on the patient's side of the table. He let on that patients found the biopsy quite tolerable - easy for him to say! Thanks for your account.

Have you considered a color Doppler ultrasound biopsy? That's a lot less intrusive, also giving less information than a saturation biopsy, but apparently gives much more information that a regular biopsy, and uses cues about new blood vessel growth to help locate and estimate the size, shape and location of any prostate cancer. There was a presentation on CDU biopsies at the 2000 and 2003 National Conferences on Prostate Cancer, in LA and Burbank, respectively, by Drs. Fred Lee and Duke Bahn.

There are some research papers on using finasteride (now generic, formerly Proscar) to improve PSA testing, improve PSA trend analysis after the baseline is reset, improve the effectiveness of the DRE exam, provide a key clue about the presence of cancer, help prevent prostate cancer safely without increasing the likelihood of high grade cancer, and perhaps reducing or eliminating low grade cancer. According to some experts, the PSA should fall by half or more after six months on the drug; if it does not, that suggests there may be cancer, and vice versa. You can find most of the key research by searching the free Government website [url]www.pubmed.gov[/url] for " thompson i [au] AND finasteride AND prostate cancer " (54 hits as of tonight for expert physician/researcher Dr. Ian Thompson from MD Anderson in Texas).

Do you use nutrition, exercise and stress reduction tactics to reduce the likelihood of prostate cancer? At least one expert, Dr. Charles "Snuffy" Myers, MD, believes they may be all that is necessary to handle mild cases of prostate cancer, and he wrote a book covering those tactics in 2006. He also favors the idea of using mild drugs like finasteride and Avodart (both in the same drug class) and a statin drug to boost the chances of prevention, or, for the statin drug, for minimizing the chance of developing advanced or lethal prostate cancer.

Good luck and take care,

Jim

[inspectormoe]

Jim, thanks for the excellent information and url site. The biopsy I had was the 25 core but the saturation one starts at 40 and goes over 100 core samples. Elsewhere on this board it was likened to removing the prostate one core at a time Like you mentioned, the doctor said the saturation was tolerable but what about the patient? I doubt the perception was the same by the patient.

I have an appt. with my local urologist next week and will ask about the color doppler ultrasound, it sure sounds a lot better than multiple core samples. The last biopsy I had was 5 yrs ago and that was the std. ultrasound, i.e. black and white so I HOPE he has upgraded.

The PCA3 plus test is still not approved by the FDA according to the statement on the lab report. I checked with my insurance prior to the test and they told me if it was a prostate screening test, it was covered. That being said, in the past they have denied cutting edge techniques calling them "experimental" or "not proven to be more effective than existing techniques." I have BC who is terrible about accepting new tests let alone ones w/o FDA approval, so we'll see. I was cautioned by the doctor's staff if insurance didn't cover the test, the price was approx. $300 which I will pay myself. As you said, I had hoped for a more definitive answer but it just seems to give more information still leaving the biopsy as the final answer. The DRE was a little more aggressive than the std. DRE to slough off cells into the bladder but not bad at all. Then you are given a container to catch the first flow from the bladder so the cell genes can be caught. From the time of the collection to hearing back from the doctor was approx. 7 days, with two of those being the weekend. Not bad at all. As far as the lab that ran the test the lab report address was located in Virginia...I live in Calif. The doctor was one of the trial PCA3 plus doctor's so he was very familiar with the test and says he gets a lot of requests for the test from men in similar situations as mine. By the graph associated with the results, I have a 30% probability of a positive biopsy result; it comes down to if I feel lucky or not.

I read where there is a brand new test that will go to trials in the Fall called the EPCA. It is a blood test that if it shows the marker the test is sensitive to, there is a 95% chance of prostate cancer. It seems there are new and improved tests being developed that maybe one day will eliminate the biopsy discomfort and invasiveness.

Thanks again for the help,

Steve

[able5]

Originally Posted by inspectormoe

I have searched the threads for info on the PCA3 test but little has been mentioned. When my PSA made a leap from 3.4 to 4.8 in 6 mos. I started doing research wherein I discovered the PCA3 plus test. Fortunately I was able to get the test which came back with a number of 33.6. 35 is the cutoff number. I.e. the lower the number the lesser the chance of prostate cancer and over the 35 cut off it increases the risk. My 33.6 puts me at a 30% probability of prostate cancer. A recheck of the std PSA showed a drop to 4.0 but the PCA3 has me concerned.

I'm 59 so I'd like to make a good decision but my last biopsy was not a good experience. 25 samples and I bled for a week along with pain etc. I guess the biopsy is the way to go but the thought of a saturation biopsy scares the bajeezus out of me. What's anyones experience with the test?

Thanks

Sorry to hear you had such a difficult biopsy procedure. Most guys on this forum will tell you they had no problem whatsoever...

Hmmmmmmmmmmmm?

Sometimes I wonder if they are being completely candid about their experience. I'm very encouraged by your honesty. If you read this forum for a while you'll see many various stories about the biopsy experience. All of them are different.

Question: Did you have your biopsy done at your doctor's office or did you go to one of these new outpatient surgery centers that are basically a high tech hospital without beds?

[inspectormoe]

Thanks for the reply. I know a lot of men have expressed the biopsy was pretty uneventful but mine was memorable I had the biopsy in the doctor's office in a room he has setup for that purpose. Part of the problem last time was the fact he nicked the uretha which wasn't fun. It maybe what led to the increased discomfort (don't you just love that word!)