Dr. Crawford on Predictive Tests in Prostate Cancer
E. David Crawford, MD, professor, Urologic and Radiation Oncology, head, Section of Urologic Oncology, University of Colorado at Denver, discusses valuable prognostic and predictive tests to help urologists determine when to biopsy, when to rebiopsy, and how to direct treatment for patients with a positive biopsy.
Crawford says when physicians break it down by these 3 “buckets,” it is easy to determine which test will be the most beneficial. There are 5 tests that fit into these 3 categories that have been validated.
When considering when to biopsy a patient, urologists should use PSA testing or PHI (Prostate Health Index), Crawford says. PHI is a newer test that helps increase the positive biopsy rate.
When considering rebiopsying a patient, urologists should use the ConfirmMDx test, which looks at DNA methylation. This test extends the biopsy range out to detect the changes seen in the cells that are not visible to the naked eye, Crawford says. PCA3, a urine test, also helps urologists determine if they should rebiopsy a patient, Crawford says.
Prolaris and Oncotype DX are the only two tests that help urologists determine which patients they should treat . Crawford says urologists need to be educated about the different tests and what they are trying to find when selecting a prognostic or predictive prostate cancer test.