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Advanced Prostate Screening Tests: PCA3 & Color Doppler Ultrasound

October 22, 2014 (Updated: August 16, 2018)
Lily Moran

During the next few years, I expect to see prostate cancer become the number one cancer among men.

Part of the problem is that myths and misconceptions get in the way of making smart treatment choices. Here are four statements I hear from patients just about every day. Can you tell which are true and which are false?

  1. A PSA test can determine if you have prostate cancer.
  2. An elevated PSA score means you have cancer.
  3. A standard biopsy is the best way to confirm the PSA findings.
  4. Prostate cancer requires immediate treatment.

All of the statements are false, even though many men wrongly believe they’re true. So let’s take a look at the correct information, because it just might save your life.

How the PSA Test Helps—and Hurts

Although the PSA test is not the final word on prostate health, I do recommend it to all of my male patients, simply as a baseline to measure changes in the PSA level over the years.

In mainstream medicine, a PSA test score below 4 is considered normal, and anything above 4 signals that it’s time for further tests, such as a biopsy.

To be clear, however, a score of 4 or more does not mean you have prostate cancer.

The PSA test is a useful tool for observing changes in your prostate, but please don’t let those test scores alone intimidate you into undergoing needless procedures that can do serious damage to your health.

A number of factors influence your PSA score, including:

  • Inflammation (prostatitis)
  • Benign enlargement of the prostate (BPH, BPE)
  • Having had sex recently
  • Changing the lab administering the test
  • Urinary tract infection
  • Riding a bicycle
  • Consuming certain foods, including sugar, red meat, and unhealthy, omega-6 fats from common oils, like corn, safflower, and soybean.

As I tell my patients, the important thing is the direction of these test scores. Are they going up or down?

An upward trend says something’s going on. That “something” could be common inflammation, which can be corrected with lifestyle changes, or it could be a malignancy.

I consider a PSA score above 1 to be reason enough to take a more detailed look at what’s going on. So, let’s say your PSA levels have been rising during the past few years. In conventional medicine, most doctors would order a biopsy.

Not so fast! There are better solutions than biopsies which are a crude hit-or-miss test at best.

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Chronic Inflammation Decoded

I start with a test known as the PCA3. This simple genetic test uses urine to look for the expression of genes that are only found in prostate cancer cells.

The PCA3 gene is over-expressed in 95 percent of all prostate cancer cases, so the test is highly accurate. Even though it has been available since 2004, not many physicians use the PCA3 test yet, so you will probably have to educate your doctor about it.

Although biopsies are commonly used to diagnose cancer, there are better methods. During a biopsy, a technician inserts a very fine needle into the organ, withdrawing cell samples that are then examined for the presence of cancer.

Numerous painful insertions—sometimes as many as 12 or more—are required to obtain sufficient samples. The problem is, even with multiple insertions, it’s possible to miss a tumor completely.

I also use a Color Doppler Ultrasound (sonogram) for my patients. It’s non-invasive, painless, and takes about 30 minutes. The Color Doppler shows prostate tumors or abnormalities. It also tells me the type of cancer, and its location, size, and stage.

If the results of these tests are inconclusive or if the cancer appears to be slow growing, “watchful waiting” is the typical recommendation. In other words, wait and see how the next series of tests goes.

I’m just not a “watchful waiting” kind of doctor, though. That’s why I suggest using the time between prostate exams to improve your health.

You can protect your prostate by watching your diet. For example, a new study shows men who eat more than ten portions of tomatoes each week cut their risk of developing prostate cancer by nearly 20 percent.

Pomegranates and pomegranate-based supplements are another prostate-friendly addition to your diet, proven to fight prostate cancer’s spread.

If you’re concerned about prostate cancer, waiting for a diagnosis can be very difficult. That’s why I urge you to research, research, research before agreeing to any procedure.

If your doctor insists that you “need” to be tested, insist on having the PCA3 test and Color Doppler ultrasound before agreeing to a biopsy.

These painless, non-invasive tests are far more accurate than older methods, they don’t have the risks of a biopsy, and they’re easier on you, too. And requesting these tests tells your doctor that you’ve been doing your homework. Don’t get sold a bill of goods on biopsies that will generate revenue for the doctor and lots of pain and expense for you.

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