Jeffrey E Wong, MD, FACS

New Blood Test to Help Urologists Evaluate and Treat an Elevated PSA

Approximately 200,000 men are diagnosed with prostate cancer each year. These men are diagnosed with prostate cancer because their primary care physicians performed a blood test known as a PSA. If the PSA is elevated or if the PSA is rising to quickly then a referral is made to a urologist. Patients may also get referred if their digital rectal exam(DRE) was abnormal or patients complain of worsening urinary symptoms.

Most men diagnosed with an elevated PSA will end up getting a transrectal ultrasound to rule out Prostate Cancer. However, there are other reasons that the PSA could be elevated, such as Benign Prostatic Hyperplasia(BPH) and Prostatitis(both of which are benign conditions). Currently the decision to undergo a prostate biopsy will depend on the PSA, digital rectal exam(DRE), and clinical history. There is a new blood test that might help men and their urologist decide whether to pursue a prostate biopsy.

There is a test called Carisome Prostate MDx 1.0 that may help us to decide if a prostate biopsy is necessary. The test looks for microvesicles in the blood that are associated with an increased risk for prostate cancer. Elevated levels of these microvesicles may mean that prostate cancer is present. A transrectal ultrasound and prostate biopsy would still be necessary to rule out prostate cancer. Here are some clinical scenarios where this new test may be useful:

The patient has already had a negative biopsy with an elevated PSA
The patient is reluctant to undergo a prostate biopsy at this time and this additional test may help him decide
The patient has a borderline PSA
The patient has a strong family history of prostate cancer

Studies will tell whether the Carisome blood test will prove to be better than PSA.

Jeffrey Wong, MD, FACS

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