HGPIN, PCA3, Boston Uros

My bf just received first biopsy results - 11 cores negative, 1 core had HGPIN. The uro has recommended another biopsy within 3 months.

The uro said if they don't find anything on the second biopsy, and assuming the PSA continues its upward trend, then we'll be riding the biopsy merry-go-round until they find PC. The general advice we've been given is that HGPIN is considered a precancerous legion, and that occult PC is generally assumed.

Does anyone know if PCA3 assays are useful in predicting biopsy outcomes in patients with isloated HGPIN?

Until we get results from a second biopsy this may be a moot question - but our goal in asking is to understand if PCA3 testing could potentially provide a marker toward future biopsy outcomes, and potentially reduce the number of biopsies on the merry-go-round.

One challenge we have is that the specialist we've been dealing with doesn't consider PCA3 as "standard care", and won't discuss the test at all, nor order it. Obviously we need to find another specialist who is more up on the latest technologies. Does anyone know of any good uros in the Boston area who are a little more current and flexible? Maybe someone at Mass General? We've seen that Mass Gen is ranked #12 in the country for PC care.

Thanks in advance for any replies/info.

Lisa

You are basically on an Active Survelience program from now on. I don't think that PCA3 would be useful in eliminating a biopsy, but it would be useful to get as it gives another baseline, much like psa, in monitoring progression and may give an indication of agressiveness.
You may also want to look into having a color doppler ultrasound as it will give a very good baseline and could eliminate some future biopsies.
Your bf's psa velocity is very high and is a concern so a 2nd biopsy in a couple of months is warrented.
Also have your uro calculate his psa density as he has the size of his prostate from his ultrasound. psa density = psa divided by(prostate size X .1) . psa density should be less than 1.5.
JT

There ARE genetic urine tests in existence that can verify the presence of cancer with great accuracy.. However, getting one performed is very difficult as they are not being marketed at this time in the United States.

One, the "Four Gene Signature Urine Test" has been licensed to both Abbott labs and Quest labs and they are both just sitting on it....

Now that the location of the PIN cells is known, you can be sure the next biopsy will focus on this area..That's how mine was found on the thrid try...

Lisa

After considering doctors around the country we decided on Dr. McGovern at Mass General.  We waited longer

so he could do the biopsy.  He is an excellent doctor and performed my husbands surgery 3 weeks ago.

Good Luck