Double-Check for Prostate Cancer

When combined with the PSA, the PCA3 test helps doctors predict cancer earlier than ever

Portrait of man

Prostate cancer is a common but exceedingly treatable cancer if caught early. This year, 17 percent of American men — about 1 in 5 — will be diagnosed with prostate cancer. Fortunately, less than 3 percent of them will die of the disease.

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One of several reasons for this exceptional success rate is the prostate-specific antigen (PSA) test. It suggests the presence of the cancer when the disease is in its earliest, most treatable, stages.

Improving on success of PSA test

The ability to test for the presence of prostate cancer got better in the past two years. A newer screening for prostate cancer, the PCA3 test, is now available at Cleveland Clinic, says Eric Klein, MD, Chairman of the Glickman Urological & Kidney Institute.

The prostate — a small, walnut-sized gland at the base of the penis — provides a fluid that protects sperm. When prostate cancers develop, they shed prostate-specific antigen (PSA) as they grow. Rising PSA levels are what the PSA test detects.

Filling in missing puzzle piece

Think of a cancer cell as a complicated picture puzzle. An antigen is one small piece of this puzzle. The appearance of an increasing number of stray pieces (more antigens) may mean the puzzle is multiplying itself — creating more cancer cells.

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But that is not always the case. “One of the problems is that a lot of non-threatening conditions also cause the prostate gland to release more PSA,” explains Dr. Klein. This is where the PCA3 test comes in. It detects another puzzle piece — the increased activity of the PCA3 gene.

“It must be understood that neither test will diagnose prostate cancer,” Dr. Klein emphasizes. “That can be done only with a biopsy — a procedure in which a thin, hollow needle is used to acquire samples of prostate tissue for study by a pathologist trained to spot cancerous cells.”

Positive versus negative

Some biopsies will be positive for the cancer and some will be negative. A negative finding is good news to the patient. However, it also tells the doctor that the biopsy may have been unnecessary.

This is why Cleveland Clinic specialists were among the first to administer the PSA and PCA3 tests, one after the other. If a suspicious digital rectal exam and PSA test suggest cancer, then the PCA3 test is given to negate those suspicions — or to strengthen them.

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“The PCA3 test should help reduce unnecessary biopsies and spare patients the worry and discomfort associated with the procedure,” says Dr. Klein.

The next step is yours

The American Urological Association recommends that prostate cancer testing begin in well-informed men aged 40 or older. By reading this, you have taken the first step toward becoming well-informed.  The next step is to ask your doctor about testing for the disease.

More information

Prostate Cancer Testing and Treatment Guide – Free Download

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