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PSA3 Test

Menstuff® has information on a PSA-3 urine test.

What is PCA3?

PCA3: a gene-based test to help deciding if biopsy is really needed
Interpretation of the PCA3 test result
PCA3 Thermometer

Nomograms for prostate cancer risk assessment
Find a PCA3 expert
Related issues: PCAW.org

What is PCA3?

PCA3 (Prostate Cancer gene 3) is a gene which is prostate cancer specific. Unlike prostate specific antigen (PSA), PCA3 is only produced by PCa cells and not affected by prostate size. It discriminates better than PSA between PCa and benign/non-cancerous prostate diseases such as benign prostatic hyperplasia (BPH, i.e. prostate enlargement) or prostatitis (infection of the prostate). Therefore, it is an additional tool in deciding if prostate biopsy is really needed.
Source: PCA3 Editorial Board, Prof. Jack Schalken Prof. Bertrand Tombal Prof. Hendrik Van Poppel. www.pca3.org/public/questions/what-pca3

PCA3: a gene-based test to help deciding if biopsy is really needed

The Prostate CAncer gene 3 (PCA3) Assay is a gene-based test. It is not a replacement for prostate specific antigen (PSA). It is an additional tool to help decide if in men suspected of having prostate cancer (PCa), e.g. those with a PSA between 2.5 and 10 ng/mL, prostate biopsy is really needed to diagnose PCa. PCA3 is, unlike PSA, prostate cancer-specific. This means that it is only produced by PCa cells and not affected by prostate size. It discriminates better than PSA between PCa and benign/non-cancerous prostate diseases such as benign prostatic hyperplasia (BPH, i.e. prostate enlargement) or prostatitis (infection of the prostate). Therefore, PCA3 gives very useful information, in addition to PSA, in deciding if biopsy is really needed.

A recent study suggests that the PCA3 Score can also differentiate between non-significant (indolent cancer) and significant PCa.

Interpretation of the PCA3 test result

The PCA3 Assay is a simple test: following a digital rectal examination (DRE), cancerous cells with high levels of PCA3 are shed from the prostate into the urine. A urine sample is then collected (click on animation to visualise). This urine sample is sent to a laboratory to determine the PCA3 Score. A high PCA3 Score indicates an increased likelihood of a positive biopsy, i.e. presence of cancer cells in the prostate. A low PCA3 Score indicates a decreased likelihood of a positive biopsy. If the PCA3 Score is low, a biopsy may be delayed or eventually avoided. In this way, the PCA3 Assay may help to avoid many unnecessary first biopsies and the potential discomfort and complications (pain, bleeding and infections) for the men involved.

The PCA3 Assay can also be used in men with one or more previous negative biopsies to predict the likelihood that another biopsy will be positive, or to assess the need for a next biopsy.

PCA3 Thermometer

If a biopsy is performed and turns out to be positive, the PCA3 Score may be used as complementary information in predicting the pre-operative risk of PCa progression and the need for early treatment.

Nomograms for prostate cancer risk assessment

Introduction
Available risk calculators
Calculating your own risk of prostate cancer progression

Introduction

In men with a suspicious digital rectal examination (DRE) and/or elevated prostate specific antigen (PSA), prostate cancer (PCa) is typically confirmed by prostate biopsy. Prostate biopsy may cause pain, bleeding and infection. Therefore, it is important to determine pre-biopsy the risk that the biopsy will contain cancerous cells. (also see: Prostate cancer diagnosis )

PCa is not lethal in all men with the disease; most men will ultimately die from causes other than PCa. Therefore, decisions about treatment type and timing are frequently guided by an estimation of the risk that the tumour will ultimately progress (i.e. local progression (lymph nodes) or distant progression (e.g. back bone) and eventually death).(also see: Prostate cancer diagnosis )

Single clinical variables alone do not predict the outcomes of prostate biopsy or potential progression of the tumour. A combination of various clinical variables can give the best prediction of PCa diagnosis and progression in individual subjects.

Diagnostic evaluations

Biopsy, Bone scan, CT scan, Digital rectal exam (DRE). Genetic tests, Lab tests, MRIPET/CT scan, ProstaScint scan, PSA blood test, Free PSA blood test, PSA3 urine test, Ultrasound, Color Doplar

Available risk calculators

CalculatorSeveral tools from different PCa research institutions have been developed to predict the risk of PCa on biopsy and its potential for progression. These are referred to as risk calculators and consist of predictive tables or nomograms. They are designed to help physicians and patients to decide whether biopsy is needed and, if PCa is confirmed on biopsy, which treatment approach would be most appropriate. They are based on the knowledge of and correct interpretation of clinical data of the individual patient. Therefore, it is strongly recommended to use the risk calculators in consultation with your physician.

A selection of well-known risk calculators, which are assessable through the Internet, is shown in Table 1. They differ in the type of population (US or European) studied and the type of clinical data which have to be known for calculating the risk, also in relation as to whether the individual men has

Table 1: Some well-know risk calculators

Predictive tables

Nomograms

Cancer Risk Calculator for prostate cancer
Pre-biopsy, US

Prostate Risk Indicator
Pre-biopsy, Europe

Partin Tables
Pre-operative, US

Center for Prostate Disease Research (CPDR)
Pre-operative, US

Kattan or Memorial Sloan-Kettering Cancer Center (MSKCC)
Pre-operative, US

Prostate Risk Indicator
Pre-operative, Europe

Most tools combine the following clinical data to predict the risk of PCa progression:

Some also add the number or percent of positive biopsy cores, the amount of cancer found in the biopsy and/or other information (e.g. radiation dose, hormone therapy use).

The Cancer Risk Calculator is currently the only risk calculator including PCA3 (Prostate CAncer gene 3). For more information see: deb.uthscsa.edu/URORiskCalc/Pages/calcsPCA3.jsp

Calculating your own risk of prostate cancer progression

Please indicate below which of the following applies to you and you will be guided to appropriate risk calculators.

Source: www.pca3.org/public/pca3/nomograms-prostate-cancer-risk-assessment

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Disclaimer: pcaw.org is produced by the National National Men's Resource Center. This web site seeks to inform and educate men on the many issues that confront them today regarding the possible dangers of prostate cancer. Information presented in this free web site does not necessarily represent the official position of NMRC. Moreover, information in pcaw.org is culled from diverse web sites and information sources. NMRC cannot guarantee the accuracy of these sources. Due to the timeliness of the information, some links will change and/or deactivate without notice.

Information is designed for educational purposes. We are not engaged in rendering medical or psychological advice or professional services. Any decisions should be made in conjunction with your physician or therapist. We will not be liable for any complications, injuries or other medical accidents arising from or in connection with, the use of or reliance upon, any information on our web site.


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