Now there’s the PSE test - uses PSA plus 5 genetic markers present with prostate cancer. Supposed to be 94-97% accurate as opposed to 51% for PSA.

I have a family history of prostate cancer (father) and experienced BPH and a fluctuating PSA for a number of years. Urologists monitored my PSA closely and I have had several MRI's and biopsies over the years. Last year I had my yearly urology appointment - PSA was stable, nothing found on the DRE. At the appointment I asked my urologist about the new urine based tests that use biomarkers to look for indications of cancer, and he indicated that he was familiar with them and that they were effective; he ordered the ExoDx test for me. Results were elevated (anything less than around 15-16 is considered normal; above that indicates a probability of cancer that should be treated. My score was 36 which means a 36% probability of clinically significant prostate cancer.) My urologist ordered a 3T Multi-Parametric MRI which was clear, and following that result said it was up to me whether he did a biopsy or not. We decided to go ahead with the biopsy and the urologist did a saturation biopsy (24 cores); 2 cores showed 5% cancer in the core. I decided to have surgery and am very pleased with the outcome.

Not surprisingly, I see a lot of value in the ExoDx test (or similar) to help identify cancer that may not be indicated by DRE, changing PSA, or an MRI.