Indications for Prostate Biopsy

Digital Rectal Exam (DRE)
suspicious for cancer at any PSA level
PSA above 3 ng/mL High Risk of prostate cancer based on multiple risk factors.
TRUS (transrectal ultrasound) Guided Biopsy. In some circumstances, Doppler ultrasound- guided or MRI-guided biopsy may be preferred or required. If TRUS-guided-biopsy not done, follow up in 6 to 12 months with PSA/DRE. Consider testing FPSA, PHI, and/or PCA3 if PSA is between 3 and 10 ng/mL. Measure free PSA (FPSA), PHI (Prostate Health Index), or PCA3 in patients with PSA 3 - 10 ng/mL

...continue reading Biopsy to Detect Prostate Cancer – when is it needed?

Already available, designed to reduce unneeded biopsies
May 18, 2015 ANN ARBOR, Mich. — A new urine-based test improves prostate cancer detection – including detecting more aggressive forms of prostate cancer – compared to traditional models based on prostate serum antigen, or PSA, levels, a new study finds.

The test, developed at the University of Michigan Comprehensive Cancer Center, is called Mi-Prostate Score, or MiPS. It combines PSA with two markers for prostate cancer, T2:ERG and PCA3, both of which can be detected through a urine sample. The test has been available clinically since September 2013. ...continue reading Urine-Based Test Improves on PSA for Detecting Prostate Cancer

This chart shows the National Cancer Center Network Guidelines, 2014, for use of the PSA test and Digital Rectal Exam (DRE) for early detection of prostate cancer. Recommendations for men over age 70 are below the chart. prostate-cancer-early-detection-chart-png

...continue reading Prostate Cancer Early Detection Flowchart

The PSA test is the first step in the early detection of prostate cancer.

As such it must be used as part of a skilled diagnostic process and selective treatment process. When to start and stop screening, at what intervals to conduct screening, and when to biopsy are among questions we look at here.

...continue reading PSA Test – do you need it?