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Question About PCA3

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Prostate Cancer
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Posted 1/3/2014 12:15 PM (GMT -5)
If a guy has dry orgasms, would the PCA3 lab still be valid? Is there a chance there is blockage that would prevent the pca3 from making it into the urine?
Posted 1/4/2014 5:33 PM (GMT -5)
If you're having retrograde ejaculation from taking an alpha-blocker, the semen goes up to the bladder and gets eliminated in the urine. Since PCA3 is a urine catch, I think it would be no problem.
Posted 1/4/2014 6:30 PM (GMT -5)
Interesting question. I don't know for sure, but it's likely the test would either give a valid result or no result.

The PCA3 test measures 2 types of RNA, and it's a ratio between a type suggestive of cancer vs "normal" prostate cell RNA. It's not measuring something called PCA3, that's just the name of the test. The PCA3 metric is a number that's a percentage reported as a whole number. So, a 31 is a 31% ratio of the RNA types. The higher the value, the more it indicates a biopsy is warranted. My UO used a cutoff of 25, and my PCA3 was 31 so we went ahead with the biopsy. Not all that high really, and I had a pretty serious tumor burden already.

If there isn't enough RNA in the sample to make a valid measurement (the test procedure verifies the levels), then it just won't give a value. You can find the test procedure on line, and it's long and complicated.
Posted 1/4/2014 7:01 PM (GMT -5)
The reason I am asking is I had the PCA3 lab done and had a 12 which indicates low probability of prostate cancer. During the DRE doctor found a firm spot, so I'm wondering what, if anything, might have caused a false negative. The small lump was confirmed by urologist.

I am scheduled for a MRI and biopsy (if necessary) in a couple of weeks, so I will know then if the PCA3 (and free PSA) were accurate or not. Both indicated low probability of cancer. My PSA had stabilized at 6.0 after being as high as 6.6, but my most recent lab (3 days ago) has PSA down to 4.6 and free PSA higher than last time it was tested.

I am having a lot of discomfort (base of penis and rectum) plus urinary problems, so something isn't right. I also feel hungry all the time and have gained considerable weight over the last 2 months.

ETA: I should have said PCA3 RNA in OP. PCA3 is the test, but it also the name of the gene (also called DD3).

Post Edited (richh) : 1/4/2014 5:04:53 PM (GMT-7)

Posted 1/4/2014 7:16 PM (GMT -5)
It's not a very good test -- just an indicator of whether to do a second biopsy. Not every cancer is positive for the gene, and the gene may be there without a cancer. It's only a false negative if your biopsy shows cancer. It actually has pretty good sensitivity (low false negatives) but poor specificity (high false positives), so a low PCA3 tells is more reliable than a high PCA3 would have. Your up-and-down PSA is indicative of prostatitis. A lump can be a lot of things. You won't know until it's biopsied.

Anxiety can cause a lot of nervous eating.

- Allen
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