Another Potential Test for Prostate Cancer
I came across an article on a newer type of molecular test that can evaluate the likelihood of a patient having clinically significant prostate cancer – in advance of a biopsy.
The novel blood test is called IsoPSA. It was developed in partnership with the Cleveland Clinic and granted Breakthrough Device Designation by the U.S. Food and Drug Administration (FDA). The test can be used in conjunction with a standard PSA test and may allow a patient to avoid an unnecessary painful test and aftermath.
Going through a biopsy
Historically physicians have used standard PSA blood testing to look for levels of 4 nanograms per milliliter or higher as a baseline for recommending a prostate biopsy. Having been personally through a prostate biopsy, I can confirm that depending upon the individual doing the testing, the biopsy target areas, and your personal tolerance levels, the reactions can vary significantly.
I have spoken with many men who have experienced prostate biopsy testing. Some report little discomfort, while others expressed a great deal of concern over the testing process. Several asked to be “knocked out” when they faced the possibility of a second test. Unfortunately, none of us know how we will react in advance.
Should you need to undergo a biopsy, I think it's good to find a urologist who has done extensive previous testing and can confirm the use of a locally-applied anesthesia as part of the process.
What the IsoPSA test can do
This IsoPSA blood test is generally used for men ages 50 and over with an elevated PSA level.1 The test can help both patient and physician decide on whether a biopsy should be performed. It does not just look at the amount of PSA in a person's bloodstream, but also at changes in the PSA protein. If an elevated PSA is found, the IsoPSA test can identify the molecular changes that are produced by cancerous and/or benign cells.
The IsoPSA test is among newer tests that augment PSA testing and may help determine a man's risk of having significant prostate cancer.
Below the belt issues
One of the "below the belt" issues men can face with advancing age is a condition called benign prostatic hyperplasia (BPH). This is basically a swollen prostate that can over time restrict or block urine flow. To relieve pressure, physicians may prescribe drugs that can decrease the swelling. While able to relieve pressure, the drugs can also affect PSA levels.
The resulting reduction in PSA levels can provide misleading information to the physician who is trying to evaluate next steps in a patient’s treatment plan. The hope with the IsoPSA test is that it's not as impacted by medications that treat BPH.
Whether the test is available
The Cleveland Clinic suggests that the test can be transformative in that it can be more accurate and specific then PSA testing alone.
But because the test is so new, patients may not be covered by Medicare or Medicaid and some insurance companies, and physicians may not be aware of it. Where it's available may also play a role. As of earlier this year, the test had mainly been offered at the Cleveland Clinic.
What was the most difficult part of your diagnosis?