Excellent News Today

hopeful and optimistic said:

Thanks for the good wishes
Your right, it was a rookie mistake........I was thinking that I was only going for a biopsy....which wasn't true at all.......in fact, in addition to a PSA, I had a PCA3(no fun at all), a blood test, a questionnaire to fill out......I also had an enigma before, and had to drive home in stop and go traffic on the freeway for about two hours, feeling where the needles went into my prostate during the ride............what a day of fun

hopeful and optimistic said:

PCA3
This test is a new investigational ( only an indicator) urine gene test that is available. The test is a molecular biologic assay. This test has a specificity of 75% and a sensitivity of 57%. (What that means is that among 100 bad tumors, for example, they only can identify 75 of them. And among 100 good tumors, they identify them as bad in 57). The test is done by a doctor who does a DRE and vigorously massages(the fun part...my doc is very experienced, has muscles on his finger, and can make a grown man cry) the prostate; the patient gives urine and the results are sent to Bostwick Laboratories(the only laboratory that does this) for analysis. It is a pretty expensive test, at I think about $500.

So the way the results work, 35 is the magic number, so the less one score is below 35 the better. Mine was 8.3 "Prostatic cells are present but do not over express the PCA3 gene", "value of 35 or greater suggests a high likelihood of prostate cancer"

It is also stated that only a prostate biopsy can diagnose prostate cancer. The test's preformance has been established by Bostwick Laboratories. It has not been approved by the United States Food and Drug administration and should not b4e used as the sole evidence for or against the diagosis of prtostate cancer. Clinicco-patholological correlation iws indicated.

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Also here is something that I had found on the internet

. I am about to have a prostate biopsy
Can the PCA3 test replace a prostate biopsy?
How does the PCA3 test help in making a decision about a biopsy?
The Progensa™ PCA3 test is not a replacement for a prostate biopsy
But the PCA3 test result can be a significant criterion in discussing the need for a biopsy. This is
particularly true for males with an elevated PSA value in which an earlier biopsy was unsuspicious (“negative”).
The result of a PCA3 test, given additional clinical and laboratory findings as well
as the patient’s history, may lead to the joint decision between the patient and the doctor not to carry out a repeat biopsy.
You can read a summary of the scientific basis for this conclusion here
Latest research results demonstrate that the PCA3 test results make it possible to estimate the malignancy
of an existing prostate cancer. This may result in sparing patients invasive therapy, should the test result
indicate that the patient suffers from a carcinoma with a low malignant potential.
You can read the opinions of practical urologists on the PCA3-test here
Yes, I would like a PCA3 test
How should I proceed? What is the next step?
5. Opinions of practical urologists on the PCA3 test
Prof. Dr. med. Bernd Schmitz-Draeger (Fürth, Germany) states:
“… with a PCA3 score below 35 the risk for prostate cancer is decreased, above it is
elevated.” Moreover he states “Let’s take a patient with a very low PCA3 value of – say
- 5: this patient has a three-time lower risk as other patients with a similar PSA
value. If we assume the risk for prostate cancer at 25% in patients with a PSA value
between 4,0 and 10,0 ng/ml, then the patient with a low PCA3 score has a risk of 8%.
This does not provide final certainty, but causes relief for the patient and the
doctor.”

4. I am about to have a prostate biopsy
Can the PCA3 test replace a prostate biopsy?
How does the PCA3 test help in making a decision about a biopsy?
The Progensa™ PCA3 test is not a replacement for a prostate biopsy
But the PCA3 test result can be a significant criterion in discussing the need for a biopsy. This is
particularly true for males with an elevated PSA value in which an earlier biopsy was unsuspicious (“negative”).
The result of a PCA3 test, given additional clinical and laboratory findings as well
as the patient’s history, may lead to the joint decision between the patient and the doctor not to carry out a repeat biopsy.
You can read a summary of the scientific basis for this conclusion here
Latest research results demonstrate that the PCA3 test results make it possible to estimate the malignancy
of an existing prostate cancer. This may result in sparing patients invasive therapy, should the test result
indicate that the patient suffers from a carcinoma with a low malignant potential.
You can read the opinions of practical urologists on the PCA3-test here
Yes, I would like a PCA3 test
How should I proceed? What is the next step?
5. Opinions of practical urologists on the PCA3 test
Prof. Dr. med. Bernd Schmitz-Draeger (Fürth, Germany) states:
“… with a PCA3 score below 35 the risk for prostate cancer is decreased, above it is
elevated.” Moreover he states “Let’s take a patient with a very low PCA3 value of – say
- 5: this patient has a three-time lower risk as other patients with a similar PSA
value. If we assume the risk for prostate cancer at 25% in patients with a PSA value
between 4,0 and 10,0 ng/ml, then the patient with a low PCA3 score has a risk of 8%.
This does not provide final certainty, but causes relief for the patient and the
doctor.”
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Yes Celebrate, with Red wine, white wine, ginger ale, a walk in the sunshine, party or whatever you enjoy........celebrate every day

hopeful and optimistic said:

Thanks for the good wishes
The doctor did not discuss why the first patholoogy determined low risk cancer while the newer biopsies were clean, however, my guess is that only a small sample of the prostate has been sampled, and that cancer within the prostate is small, not large enough to be identified by the MRI machine, or that there is human error in taking a biopsy in the exact place identified by the MRI. In any case, I strongly believe that there is stil cancer within the prostate; however, I am an excellent candidate for Active Surveillance with Delayed Treatment.

When I first choose AS as a treatment, I was uncomfortable with the decision, since the possible consequences are scary, however, as I am better educated about this treatment option, and the benefits of a closely monitored surveillance program, I am more and more comfortable with the decision I made to follow an active surveillance program, however I have concerns, that the technology to identify cancer within the prostate and the aggressveness of these cancers by type on a molecular level still need to improve in order to more effectively identify patients that need treatment versus those who do not. Additionally I think that developing a program of various markers that are current and new ones is another way to help in monitoring this disease among patients.