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Questions about Prostate Screening EpiSwitch (PSE) testing

Posted by billfarm @billfarm, Nov 2 8:07pm

Pse testing appears to be a tool to validate or debunk psa numbers. I had psa 18 Gleason 9 grade 5. Had surgery and psa failure. 1.8 then 2.3 post surgery. On Orgovyx/zytiga 20 months immediately psa went undetectable and stays there.Planning intermittent adt. The question is if and when psa rises will pse forecast return of pca sooner? Also will Medicare pay and where is pse test available?

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northoftheborder | @northoftheborder | Nov 14 10:25am
In reply to @bens1 "Guys: I just got my PSE test back to see if it showed biological re-occurrence. I..." + (show)
@bens1

Guys: I just got my PSE test back to see if it showed biological re-occurrence. I have attached it without my personal info. When I asked about the 9 out 10 men and absence of cancer statistically, this is what they said:

"our Negative predictive value (NPV) is 95% - 95 out 100 are truly negative. The stats come from a study of over 400 men in a clinical study and the principal investigators, not the company."

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Thanks for that. This helps confirm what I've been piecing together: from my understanding, the extra epigenetic test (the "E" in PSE) isn't useful if your PSA is normal/low/undetectable; however, if your PSA is high, adding the "E" can help you determine more accurately how much it matters.

So as long as my PSA remains < 0.01, PSE holds no value for me; but if it were to start climbing to (say) 10, the extra epigenetic test would help me know whether the cancer was spreading quickly yet and choose an appropriate treatment course.

Does that sound right?

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1 reply
jeffmarc | @jeffmarc | Nov 14 11:18am
In reply to @bens1 "Guys: I just got my PSE test back to see if it showed biological re-occurrence. I..." + (show)
@bens1

Guys: I just got my PSE test back to see if it showed biological re-occurrence. I have attached it without my personal info. When I asked about the 9 out 10 men and absence of cancer statistically, this is what they said:

"our Negative predictive value (NPV) is 95% - 95 out 100 are truly negative. The stats come from a study of over 400 men in a clinical study and the principal investigators, not the company."

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Have you had an undetectable PSA for a long time? How long?

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1 reply
bens1 | @bens1 | Nov 14 11:31am
In reply to @jeffmarc "Have you had an undetectable PSA for a long time? How long?" + (show)
@jeffmarc

Have you had an undetectable PSA for a long time? How long?

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@jeffmarc I had the mridian narrow margin radiation hypo fractional 5 treatments so my psa will be higher than those that have had their prostate removed.

My last psa test was .8 (point). My lowest was .72 (point). My highest, before my treatment, was 11.2.

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jeffmarc | @jeffmarc | Nov 14 11:39am

Good to hear that you can have a little bit elevated PSA and the PSE test shows that you’ve got a very low chance of reoccurrence.. it would be interesting to follow you for a few years to see if the results are confirmed.

Great news.

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bens1 | @bens1 | Nov 14 11:45am
In reply to @northoftheborder "Thanks for that. This helps confirm what I've been piecing together: from my understanding, the extra..." + (show)
@northoftheborder

Thanks for that. This helps confirm what I've been piecing together: from my understanding, the extra epigenetic test (the "E" in PSE) isn't useful if your PSA is normal/low/undetectable; however, if your PSA is high, adding the "E" can help you determine more accurately how much it matters.

So as long as my PSA remains < 0.01, PSE holds no value for me; but if it were to start climbing to (say) 10, the extra epigenetic test would help me know whether the cancer was spreading quickly yet and choose an appropriate treatment course.

Does that sound right?

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@episwitchpse what do you think about @northoftheborder's question?

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episwitchpse | @episwitchpse | Nov 22 10:37am
In reply to @northoftheborder "Thank you for that post. Would PSE have any added value for someone who's been on..." + (show)
@northoftheborder

Thank you for that post. Would PSE have any added value for someone who's been on ADT+Apalutamide for several years to manage mCSPC, and has undetectable PSA (< 0.01)?

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Hi, thanks for the question. To be clear - this is for informational purposes, and should not be construed as medical advice. Definitely consult your personal physician for each unique situation. In the situation with an undetectable PSA (< 0.01) on Relugolix and Apalutamide, would the test change the management plan if the PSA continues to remain undetectable? At this juncture PSE may not be needed while the PSA continues to remain undetectable as it would not likely change a urologist's management plan. If your PSA starts rising a bit, but the PSE comes back consistent with Low likelihood - it might give you and your provider the confidence to remain on the current therapy and hold off on changing courses.

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