Prolaris test?

[Eadgbe]

Does anyone know about the "Prolaris" test? I'm about to do my 2nd biopsy and if I can prevent it I will. The 2nd one is an MRI guided one, to determine what kind of anomaly I have. Does the Prolaris tst do the same thing? I've already had a 4k test and PSA is rising.

[Tall_Allen]

The purpose of Prolaris is to assess your genomic risk. It is useful if you have already been diagnosed with favorable intermediate risk prostate and considering staying on active surveillance. Its purpose is not to avoid a biopsy.

The PIRADS score of your mpMRI and your 4Kscore are the tools you should be using to decide if a biopsy is warranted,

[Eadgbe in reply to Tall_Allen]

Thank you so much for your response. My 4k score was Elevated PSA - 790.93. I don't know what the PIRADS score of my mpMRI was 4 . I have no idea what all that means. I'm a novice at this domain.

[Tall_Allen in reply to Eadgbe]

4K scores are percents (0%-100%). Scores above 7.5% are reason to have a biopsy.

4 on PIRADS means there is an area of your prostate that is suspicious for cancer - you cannot know for sure without a biopsy. They should take 4 biopsy cores from that area.

You should not have a Prolaris test unless your biopsy results are equivocal for active surveillance.

[Eadgbe in reply to Tall_Allen]

Thank you. Being new to this, and my urology office communications is very bad, I appreciate other voices that clarify things.

[addicted2cycling in reply to Eadgbe]

Should you have another biopsy, INSIST that it is done transperineally and NOT via rectum (TRUS).

* Transperineal ultrasound-guided (TP) biopsy reduces the risk of post-procedural sepsis versus transrectal ultrasound-guided (TRUS) biopsy. TP biopsy can be performed safely as an outpatient, under local anaesthetic. TP biopsy can successfully replace TRUS biopsy in diagnosis of prostate cancer.*

Also note that a TRUS biopsy does not reach areas of the prostate known to contain higher Gleason Score PCa.

[Eadgbe in reply to addicted2cycling]

My urologist office says the TRUS is what they do because of the specialized equipment they have. That's not reassuring to me. I will get a 2nd opinion today or tomorrow.

[addicted2cycling in reply to Eadgbe]

IMO, there is nothing specialized about TRUS equipment. That talk is blah-blah-blah. 👍👍regarding second opinion.

[Hidden in reply to addicted2cycling]

Yeah, I never liked the idea of someone sticking a large needle through the wall of my rectum.

[allie2020]

It is really good that you found this site and guys will help you all they can. You have already met our #1 expert, Tall_Allen. It's probably time for you to educate yourself about the basics of prostate cancer, testing, etc. You can look at your 4K test and there will be a number with a % there. It tells you the % chance that significant cancer will be found upon biopsy. It looks like your MRI discovered one or more PIRADS 4 lesions. If your PSA is 790, that is pretty high. Your next biopsy should be a "targeted biopsy" where your Urologist uses the MRI for guidance. Stick with us here and don't let any Urologist or anyone else rush you in to anything.

[maley2711 in reply to allie2020]

what a sad state of affairs that such advice must be given re the state of communication with so many Docs. They haven't the time apparently....assembly line doesn't permit it .

[groundhogy]

From my experience, a positive biopsy is the only evidence that will be accepted as proof of cancer.

[Seasid in reply to groundhogy]

I don't understand fully your statement. Who needs the evidence of the cancer when your PSA is 790?

[Eadgbe in reply to Seasid]

I don't think that is the PSA reading.

[Seasid in reply to Eadgbe]

I was also wondering about that.

[addicted2cycling in reply to Seasid]

High PSA has other causes ---

healthline.com/health/mens-...

[groundhogy in reply to groundhogy]

I was implying that if one wants action/treatment, you must move to biopsy. Secondly, it shows that the industry itself has little faith in the accuracy all of its other diagnostic tests.

[Seasid]

Could you do the PSMA PET scan?