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Stable elevation of PSA

Posted by drj @drj, Nov 8 8:33am

My brother-in-law's PSA has been running around the 7 ng/mL level for several years. HIs urologist has found nothing to explain this including biopsies and suggests that is simply his normal level. Has anyone heard of such levels being benign or "normal"? I believe it is infrequent, but not uncommon, in some men to see some bumps up in PSA that do not repeat next time, but steady elevations?

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bens1 | @bens1 | Nov 10 8:11am
In reply to @drj "@bens1 This test was announced in 2024 I believe. It combines PSA with tests for some..." + (show)
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@bens1
This test was announced in 2024 I believe. It combines PSA with tests for some "epigenetic" gene changes to get better accuracy.. This test is available from a single private lab, and perhaps with limited availability.

I know little about this test, which is a thoughtful and promising idea, nor the detail of their clinical data, particularly their PSA data. Without digging deeper, their comparative claims of PSA clinical performance raises questions for me.

First, was the PSA data taken from the medical literature? Was it based on simply the finding of an elevated PSA followed by a biopsy? PSA should only be used by an established rising value over time. A single value by itself would be improper clinical use of PSA. I don't think I've looked at recent sensitivity and specificity data for PSA using specific PSA "velocity" or trending criteria. I'm sure it exists, and I would expect it to be better than the data the company reports for PSA.

Second: How was the biopsy done in the PSA data group? Was it done with the accuracy of targeted MRI/US Fusion biopsies? Dramatic impact on sensitivity and specificity calculations versus earlier 12 Core TRUS biopsies, or systematic biopsies.

I'm not going to dig into the study designs and the data quality. These are the questions I immediately think of if I were to look.

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@drj
Reasonable questions. The VP of Clinical Diagnostics at Oxford Biodynamics is Joe Abdo. His email address is: joe.abdo@oxfordbiodynamics.com. Maybe he can shed some light on your questions, if you want to contact him. He has been willing to talk in the past. He has also said that it is hard for him to constantly monitor this site but I will include his tag here as well @episwitchpse. I am assuming, for the moment, that it is still active.

In terms of availability of the test, I had originally called the company and asked them to forward their "test kit" to my doctor which in my case was my general practitioner as the test came out after my treatment. I wanted to try it out for biological re-occurrence, which Oxford Biodynamics said the test would also catch. I felt I should try it. Medicare paid for it but I heard sometimes they do not. My PSA had taken a small hop up in one quarter and, although I knew that could be for a few reasons, I wanted to see their results.

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jeff Marchi | @jeffmarc | Nov 10 11:09am
In reply to @drj "@bens1 This test was announced in 2024 I believe. It combines PSA with tests for some..." + (show)
Profile picture for drj @drj

@bens1
This test was announced in 2024 I believe. It combines PSA with tests for some "epigenetic" gene changes to get better accuracy.. This test is available from a single private lab, and perhaps with limited availability.

I know little about this test, which is a thoughtful and promising idea, nor the detail of their clinical data, particularly their PSA data. Without digging deeper, their comparative claims of PSA clinical performance raises questions for me.

First, was the PSA data taken from the medical literature? Was it based on simply the finding of an elevated PSA followed by a biopsy? PSA should only be used by an established rising value over time. A single value by itself would be improper clinical use of PSA. I don't think I've looked at recent sensitivity and specificity data for PSA using specific PSA "velocity" or trending criteria. I'm sure it exists, and I would expect it to be better than the data the company reports for PSA.

Second: How was the biopsy done in the PSA data group? Was it done with the accuracy of targeted MRI/US Fusion biopsies? Dramatic impact on sensitivity and specificity calculations versus earlier 12 Core TRUS biopsies, or systematic biopsies.

I'm not going to dig into the study designs and the data quality. These are the questions I immediately think of if I were to look.

Jump to this post

@drj
The PSE test detects the presence of prostate cancer in your bloodstream. If it doesn’t find it, that means a biopsy is almost definitely not necessary.

That is the purpose of the test. To detect prostate cancer in the blood.

It is not a substitute for a PSA test.
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