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PCA3

avocat
Posts: 14
Joined: Jun 2011

All: Negative 12 snip biopsy 27 months ago. PSA rising (3.5 to avg. 6) and PCA3 of 36.5. Biopsy next week. Should I kill myself now or wait? :) SC

VascodaGama's picture
VascodaGama
Posts: 1590
Joined: Nov 2010

Avocat

Welcome to the board.
PCA3 (aka DD3), is highly specific for prostate cancer cells. It doesn’t tell you if you have cancer but the probabilities for finding cancer in your biopsy. Surely your purpose is to find a reason for an elevated PSA (now at 6.0) and at the same time to ascertain that you are cancer free.
Avoiding the “killing” as you name it, due to the inconvenience, pain and effects from a Biopsy may be a choice. Nevertheless you need to be cautious because both, the PCA3 score and the PSA level are at the mid limits for a probable positive result.

PCA3 score of 35, in the usual scale from 4 to 125, is the “zero flag”. Your value 36.5 is just one percent point above zero but the PSA of 6 in non-confirmed cancer cases (negative biopsy) is at the limit of the gray-zone taken as a laboratory standard in the bracket of 4 to 6 (0 to 4 is normal).
Other factors could be behind the increase in PSA. Your age, passing stool or manipulations of the prostate gland (sex, etc.) in the day before drawing blood, etc., can cause an increase.
A point of consideration in your diagnosis is that the PSA progress has a slow growth which may be indicative for an indolent type of cancer if the bandit is ever found in you.

Do it or not is a tuff decision. Your follow-up doctor is the best to give you an answer.
My own private comment as a layman (do not use it as a decision), if not satisfied with the inconvenience of the biopsy, I would inquire with the doctor in regards to a delay of the procedure based in these two conditions; (1) get PSA tests on 6-months using a trigger PSA of 8 to commit to biopsy; (2) repeat the biopsy not later than 12 months from the date of today, even if PSA stables within this period.

Here is a study you might be interested in reading;
“…This gene PCA3 encodes a novel class of genes, namely the ones that are not translated in a protein and apparently function as a structural RNA…”
http://www.noviogendix.nl/files/Literatuurbrochures/Tinzl_pca3.pdf

Hope my insight is of help.

Take care
VGama

avocat
Posts: 14
Joined: Jun 2011

Thanks - very helpful. I trust this doc and he has suggested a biopsy. Think I will probably go through with it. No fun, but if something shows up I want to jump on it. Regards, steve cook

hopeful and opt...
Posts: 1353
Joined: Apr 2009

is the test that is critical. Good idea to make sure that you doc takes at least 12 cores in the biopsy.

The PSA and PCA3 tests are indicators only.

The PSa can be affected by an infection, manipulating, sex, bike riding, exercise for a day or two before the test. I wonder what the rate of rise isfor you Psa. When did it start to rise?

Hopefully, the results from your biopsy will be benign however prostate cancer is generally very treatable.

avocat
Posts: 14
Joined: Jun 2011

thanks for your comment. PSA has been rising slowly for several years. Will probably go ahead with biopsy number 2. Regards, steve cook

hopeful and opt...
Posts: 1353
Joined: Apr 2009

At the Sloan Kettering web site you will be able to determine what the rate of change is for your PSA, the time it takes to double.

I had a diagnosis of Prostate Cancer about 2 and 1/2 years ago. Low volume, low aggressive cancer was found. I am in an Active Surveillance program. So far I have had 3 biopsies. The next one will be in two years.

If you wish, you can click my name you can read about what I have been doing to monitor my cancer.

I am always apprehensive before a biopsy. Once again, the biopsy is the main test that will let you know where you stand. All of the other tests are simply indicators.

avocat
Posts: 14
Joined: Jun 2011

Steve: Thanks, I appreciate the feedback. I'll check the site you mentioned. I'm glad things are going good for you. Regards, SC

hopeful and opt...
Posts: 1353
Joined: Apr 2009

Yes things(temporarily) are going well for me. It is a combination of luck and working at being informed. There are a many who I have come across, and you will come across, both doctors and lay people who will be self serving or ignorant, and give you bad guidance.

I cannot emphasize enough the importance of being informed so you can avoid pitfalls that are out there. This discussion site is a good source, so are face to face support groups, books, internet, organizations that are avocates for prostate cancer patients, etc. etc

VascodaGama's picture
VascodaGama
Posts: 1590
Joined: Nov 2010

For you guys on the diagnosis “platform” (though each case is different), I would like to opinion and suggest you to get a Colour Doppler added to your scope of tests.
If practical, this non-invasive test can provide you an inner picture of any newer blood vessel formation and flow in the prostate “surrounds”.
This seems to be typical on any activity of microscopic cancer.
A comparison of tests can help in identifying possible existence of non-detectable cancer by a biopsy.

Regards.
VGama

hopeful and opt...
Posts: 1353
Joined: Apr 2009

Since it will be two yaars from now that I am scheduled for another biopsy, this test may be worth considering before the next scheduled biopsy.
By the way I have heard that regular biopsies will do the job, and a color dopler is not required, however I will investigate.

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