The most common screening tool for prostate cancer is the prostate-specific antigen (PSA) test. This is a simple blood test that measures the presence of PSA circulating in your bloodstream. This test is usually the first step in any prostate cancer diagnosis. However, the PSA screening by itself cannot tell you if cancer is present.
Recent research has yielded additional tests that – in addition to the PSA and subsequent DRE (Digital Rectal Exam) and Biopsy – that can give a doctor more information on to determine the probability of both finding cancer during a biopsy and determining how aggressive that cancer is likely to be.
- A test identifying risk of aggressive disease upon biopsy, predicting the probability for high-grade prostate cancer.
- The Prostate Health Index combines three blood tests that give a more accurate “Phi Score,” which gives accurate information based on a high PSA to better determine the probability of finding cancer during a biopsy.
- A urine test that more accurately detects the possibility of prostate cancer by examining the expression of PCA3 – a gene specific to prostate cancer. The PCA3 score is used to determine the need for repeated biopsies. Research has continued for years to look into whether PCA3 can replace or serves as a substitute for the PSA test.
- A blood test providing patient-specific probability of finding an aggressive form of prostate cancer during a biopsy. Doctors and patients can then make an informed decision on whether to have a biopsy. The test measures total PSA, free PSA, Intact PSA and for certain enzymes called kallikrein. An algorithm used with the patient’s age and physical exam gives a probability percentage of having aggressive disease.
While none of these tests are conclusive on their own, when performed in addition to a PSA test, DRE (Digital Rectal Exam), and a biopsy, they can provide each patient with more information about their specific cancer and can aid in both the diagnosis and decision on treatment.