Enter the PCA3 Prostate Cancer Test

I mentioned that my urologist also wanted to make sure that the traces of blood in my urine weren’t due to some other urinary problem.  So, I had an ultrasound of the kidneys to check for tumors and stones and possibly other issues.  My results were negative.  The only unusual item was a small cyst on one kidney.  Apparently, these cysts are fairly common and require nothing but a check every few years.  That was a relief.

The next procedure wasn’t quite so easy.  Another concern was a urinary infection or bladder cancer.  The way they check for this isn’t real pleasant and, to be honest, caused me a fair amount of anxiety.  I’m now thankful that in 40 years, I’ve never had to have a catheter.  Apparently, the scope used for a cystoscopy is a glorified catheter that takes video and has some other gizmos.  First, you get some local anesthetic put up your urethra.  Even though no needle was involved, it was not real fun.  The scope wasn’t much fun either.  Plus, they fill you full of fluid to expand the bladder so they can take a good look.  Still, overall, not so invasive and it wasn’t as bad as I had anticipated.  It took maybe 10 minutes, not including the anesthesia and waiting time until the procedure.  Side effects include having the constant urge to urinate and a burning sensation, which lased a couple hours for me.  On the plus side, all was normal on this exam, too.  No indications of anything unusual from inside.

At this point, the urologist said the only thing left to do was the biopsy, which I then scheduled for early January.  It would have been earlier this week, in fact.  On my way out, the nurse said she’d call me in an hour or two with the results of the urine specimen I gave before the procedure.  I asked if it was for another check for blood in the urine.  They said it was a different test that could detect proteins specific to cancer of the bladder.  I found out it was called an NMP22 test.  My results were negative.

That turned on a light bulb, though.  If they test for bladder cancer through the urine, surely they can do the same for prostate cancer.  Back to Google.  I was right.  There has been a test used for some time in Europe called a PCA3 test for prostate cancer specific markers in the urine, similar in principle at least to the NMP22 one I had for bladder cancer.  I discovered it was available in the USA, though it was relatively new and not yet officially FDA approved or accepted as a valid test here.  On the other hand, there are labs in the USA certified to do this test and it is covered by some insurance plans, too.  The test apparently has drawbacks.  It may not detect all types of prostate cancers and it wouldn’t detect those that manage not to release this protein into the normal prostate secretions.  So, like a biopsy, there is still a risk of false negatives.  There are apparently other new tests coming soon, including one called the EPCA-2 blood test.

Wouldn’t this be the exact kind of non-invasive test that should be done in a case like mine, before a biopsy?  Funny thing was, I had asked my urologist exactly that.  Was there any kind of CT scan, urine test, blood test, MRI or anything non-invasive that could be used instead of a biopsy.  The answer had been “No.”  I’m glad I didn’t take that as the final answer.

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