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New type of test for PSA: Prostate Screening EpiSwitch (PSE) test

Posted by Joe M. @joem, Nov 2, 2024

First of all I want to thank all of those that responded. I has helped me in my fear and anxiety of what route to take.
Have any of you heard of the following new test called the Prostate Screening EpiSwitch (PSE) test that is showing promise as a more accurate alternative.
As reported the PSE test demonstrated 94% accuracy, significantly reducing false positives and unnecessary biopsies compared to PSA testing alone.

The PSE test aims to be minimally invasive and cost-effective, making it suitable for both diagnostic and screening purposes.

I value your opinion.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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skimore | @skimore | Apr 14 5:47pm

Thanks for the quick response Jeff, and clarifying your thoughts on transperineal. If other folks have experience with ISOpsa versus Episwitch, whether medicare covers Episwitch, and thoughts on when a visit to Mayo would be appropriate, that information would be much appreciated.

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gently | @gently | Apr 14 8:45pm
In reply to @skimore "Greetings, I appreciate this forum and value the insights and feedback. Currently assessing next steps based..." + (show)
Profile picture for skimore @skimore

Greetings, I appreciate this forum and value the insights and feedback.

Currently assessing next steps based on a psa>8, ISOpsa>6 positive, and negative MRI. Wondering if EPIswitch should be expected to add any additional insight over ISOpsa prior to considering a biopsy as a next step. Second, does anyone have experience with Medicare paying for EpiSwitch? Lastly, curious if any reason to plan my visit Mayo prior to biopsy, or better to wait for biopsy results? Thanks!

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@skimore, Episwitch epigenetics tells you likely or unlikely, which would be more reassuring if they'd give you the grid of testing results.
Medicare pays for the test, but not for the draw, unless the draw is done in the doctor's office.
https://cancerworld.net/new-prostate-cancer-blood-test-psa-epigenetic/
ISO/PSA looks at structural changes in the PSA and is said to have 80% accuracy.
It sounds like you've a biopsy scheduled and plan on going to Mayo after. I'd read Jeff's post carefully and have a second opinion on whether you need the biopsy at all. That would be worth contacting Mayo for.
I hope you are negative

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skimore | @skimore | Apr 15 10:44am
In reply to @gently "@skimore, Episwitch epigenetics tells you likely or unlikely, which would be more reassuring if they'd give..." + (show)
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@skimore, Episwitch epigenetics tells you likely or unlikely, which would be more reassuring if they'd give you the grid of testing results.
Medicare pays for the test, but not for the draw, unless the draw is done in the doctor's office.
https://cancerworld.net/new-prostate-cancer-blood-test-psa-epigenetic/
ISO/PSA looks at structural changes in the PSA and is said to have 80% accuracy.
It sounds like you've a biopsy scheduled and plan on going to Mayo after. I'd read Jeff's post carefully and have a second opinion on whether you need the biopsy at all. That would be worth contacting Mayo for.
I hope you are negative

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Thanks, this is very helpful additional insight @gently
I agree with your view that getting a range(grid) over just a positive/negative would be helpful.
I have a number of positive indicators like PSA, PSA trend and density and ISOpsa pointing to additional investigation, versus a negative MRI which based on this forum is not sufficient to avoid biopsy. I am scheduled for a second MRI and I am considering EPIswitch to potentially delay/eliminate the biopsy per your and Jeff's guidance.
I am very interested to connect with Mayo, but unfortunately they have eliminated virtual consults as a first contact. So cost would be a flight + hotel + consult to consult on my numbers and whether the biopsy is needed. Based on my reading of the research and forums it would be unlikely to avoid the biopsy without a more conclusive negative indicator like Episwitch.
Thanks for your thoughts, I hope I am negative too!

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2 replies
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Jeff Marchi | @jeffmarc | Apr 15 11:12am
In reply to @jeffmarc "@skimore If the PSA tests comes back negative, you don’t need to take a biopsy. That’s..." + (show)
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@skimore
If the PSA tests comes back negative, you don’t need to take a biopsy. That’s really the purpose of having it. They will tell you whether there is prostate cancer in your body. With a Gleason six there may not be.

If you do have a biopsy, try to get a transperennial Instead of transrectal. Less chance of infection and they can get to more of the prostate that way.

You should have an MRI before you have a biopsy so they know where to look and know where to take samples, It should be a guided biopsy.

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@jeffmarc
Unfortunately, the spellchecker corrected this incorrectly.

It should’ve read

If the PSE tests comes back negative, you don’t need to take a biopsy. That’s really the purpose of having it. They will tell you whether there is prostate cancer in your body. With a Gleason six there may not be.

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jim18 | @jim18 | Apr 15 11:30am
In reply to @skimore "Thanks, this is very helpful additional insight @gently I agree with your view that getting a..." + (show)
Profile picture for skimore @skimore

Thanks, this is very helpful additional insight @gently
I agree with your view that getting a range(grid) over just a positive/negative would be helpful.
I have a number of positive indicators like PSA, PSA trend and density and ISOpsa pointing to additional investigation, versus a negative MRI which based on this forum is not sufficient to avoid biopsy. I am scheduled for a second MRI and I am considering EPIswitch to potentially delay/eliminate the biopsy per your and Jeff's guidance.
I am very interested to connect with Mayo, but unfortunately they have eliminated virtual consults as a first contact. So cost would be a flight + hotel + consult to consult on my numbers and whether the biopsy is needed. Based on my reading of the research and forums it would be unlikely to avoid the biopsy without a more conclusive negative indicator like Episwitch.
Thanks for your thoughts, I hope I am negative too!

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@skimore If no PIRADs identified in MRI either bad MRI / MRI reading or no significant cancer. A PIRADs of 2 is non-cancerous over 85% of the time; PIRADs 3 over 75%. Did not mention how much over 6 the ISOpsa was, but that is the breakpoint so if 6.x still fuzzy. If concerned get the Episwitch PSE since they will give you a yes or no for biopsy. It would be better if there was a gradient, but most genetic tests are "black boxes" so not unusual. A negative biopsy even random is considered definitive and eliminates the "medical necessity" of the PSE.

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gently | @gently | Apr 15 10:15pm
In reply to @skimore "Thanks, this is very helpful additional insight @gently I agree with your view that getting a..." + (show)
Profile picture for skimore @skimore

Thanks, this is very helpful additional insight @gently
I agree with your view that getting a range(grid) over just a positive/negative would be helpful.
I have a number of positive indicators like PSA, PSA trend and density and ISOpsa pointing to additional investigation, versus a negative MRI which based on this forum is not sufficient to avoid biopsy. I am scheduled for a second MRI and I am considering EPIswitch to potentially delay/eliminate the biopsy per your and Jeff's guidance.
I am very interested to connect with Mayo, but unfortunately they have eliminated virtual consults as a first contact. So cost would be a flight + hotel + consult to consult on my numbers and whether the biopsy is needed. Based on my reading of the research and forums it would be unlikely to avoid the biopsy without a more conclusive negative indicator like Episwitch.
Thanks for your thoughts, I hope I am negative too!

Jump to this post

skimore, you could get a second opinion closer to home. You have a better grip on this than I
had/have. Episwitch is easy.

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