Last week I mentioned my PCA test results. Here is a copy of the report from Bostwick Laboratories.
I have not yet been able to find a “calculator” that gives you a risk based on your PCA3 score, as there are for PSA levels. I have found some interesting webpages and studies about results that may be of help to anyone considering a PCA3 test, because of concerns about a biopsy or repeat biopsy–
http://www.prostate-cancer.org/education/preclin/Torres_PCA3.html
http://www.pca3.org/pro/pca3-utility
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=18295257
http://www.ncbi.nlm.nih.gov/pubmed/18353398
http://www.ncbi.nlm.nih.gov/pubmed/18801539
You can find a large number of other studies and research using Google. It’s pretty clear that there has been a lot of work done to see if this is a legitimate diagnostic tool. Though the test is not yet FDA approved or widely accepted as a tool for detecting prostate cancer, there are labs certified to do the test in the USA and some insurance companies already cover the cost of the test. There is clearly some value in this test, especially when used with other results in an overall effort to determine if a biopsy or repeat biopsy is needed. There is also developing evidence that this test can help determine if a prostate cancer is likely to be significant (large volume, aggressive and/or extending outside the prostate).
What does all this mean?
Well, in my case, with a relatively low score of 5.6, the risks of me having prostate cancer are probably low, but still a real possibility. It’s also likely that if I do have prostate cancer, it isn’t yet significant in terms of size or being aggressive and spreading outside the prostate.
I should know more next week, after my ultrasound.
Careful on not doing a biopsy. I’m Gleason 6 with two recent PSA’s of 4.6 and 5.7. But all six cores on the right side of the prostate were positive. Thus, it is a large tumor and I already have perineural invasion (my reading suggests that is the first step for the cancer to escape the prostate). Needs to come out RIGHT NOW.
After the biopsy, my oncologist had a PCA3 done as part of a clinical study. The score was only 16.4 (PCA3/PSAx10-3). That rates as less than 20% chance of even having prostate cancer, let alone a large tumor.
Obviously, I have it and it is quite a substantial tumor. I’ll probably be ok after RP. But both oncologists I consulted said it needs to come out now and not later based on the results from the biopsy.
At least in my case, the PCA3 results could have lead to bad decisions about biopsy had the test been performed before the biopsy (I’m a worrier and would have had the biopsy in any case at the point PSA went to 5.7–for me, 20% probability is quite a bit too high).