Video: Should You Get a PCA3 Test? | Helpline Questions

Helpline Questions | Transcription

Hi, I'm Dr. Scholz.

A question we get at the PCRI is, "What is PCA3 and what does it do?"

PCA3 is a urine test; PCA3 itself is a substance in the urine that is secreted by prostate cancer. So if you visit your family doctor or your urologist, and they're wondering if you have prostate cancer—maybe your PSA is running high—they'll ask you to submit to a digital rectal exam to put some pressure on the prostate and force some prostate secretions into the urethra. Then they'll collect a urine specimen and it'll go off to a laboratory and if the PCA3 levels are elevated, that could indicate that prostate cancer is present. 

PCA3 is one of a number of different such tests. People have been trying to figure out what to do with high PSA levels for a long time. Random biopsy has been the standard approach. Now we're recommending MRIs. But there are other such tests besides PCA3, for instance, Free PSA, ExoDx, OPKO 4K. PCA3 is actually one of the earlier iterations of all this sort of thing, and some of the newer tests actually are more specific for the types of prostate cancer that you want to know about. The Gleason 7's and higher. They don't point out the Gleason 6's and lower—the ones you don't really even want to know about. And that was a problem with PCA3. PCA3 was non-specific. So if it's elevated, it could be elevated from Gleason 6 or 7 or 8, and it wasn't really helping us very much decide who should be getting biopsies, who should be getting MRIs. 

So PCA3 is still on the market and you can still get it, but because of its lack of specificity, I don't usually recommend it. Just as I don't recommend the Free PSA anymore and some of these older tests that were designed to find any type of prostate cancer rather than honing in on the more serious types of prostate cancer that need to be diagnosed.