Prostate cancer tests improving with new technology

When 54-year-old Jeff Rolf went in for his annual physical three years ago, he did not expect to come away with news of an abnormal PSA level and, eventually, a prostate cancer diagnosis.

But the level of prostate-specific antigen (PSA) in Rolf's blood had slowly increased between 2000, the year he first took the PSA test, and 2008. Doctorsbecame concerned not because the level was particularly high, but because it trended upward through the years.

Rolf chose to have a biopsy, which was positive for cancer. The Brecksville, Ohio, resident, a vice president of marketing at a major aerospace engineering firm, had a radical prostatectomy in 2009, and underwent radiation therapy in 2010.

"If there's a poison in your body, it’s a human reaction to say, 'Get it out of me,'" Rolf told ,Doctors say the PSA test is the best thing out there for prostate cancerscreening, but it's infamous for its lack of specificity. Many times, an elevated PSA level could be due to an enlarged prostate, inflammation or infection rather than cancer, said Dr. John Wei, a professor of urology at the University of Michigan Health System.

And even if the PSA test indicates a high risk of cancer, it's unable to differentiate between a slow-growing, nonlethal cancer and that of a clinically significant cancer, Wei said.

That may all change in the near future. The prostate cancer antigen-3 (PCA3) test, which is available for use but has yet to be approved by the Food and Drug Administration, measures urine levels of the genetic material mRNA. High levels of mRNA indicate an increased risk of cancer, and the results of a PCA3 test can add reliability to those of a PSA test to reduce false positives, Wei said.

Looking into the future

It's impossible to predict when the FDA will approve the PCA3 screening test, according to Gen-Probe. But because screening tests are not the same as drugs, doctors are still able to use versions of the PCA3 test with the caveat for patients that even though it isn't yet FDA-approved, it has been shown to work in clinical trials.
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