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Prostate Health Index
17th Feb

2014

Prostate Health Index (phi): a better way to test for Prostate Cancer.

Prostate cancer is the second largest cause of male cancer deaths. Roughly 18,700 Australian men are diagnosed every year, with more than 3,000 men dying as a result of prostate cancer. It’s a life-threatening disease and catching the disease in its earlier stages provides the best chance of recovery. Luckily, there is a new blood test that can assist in detecting prostate cancer. Let’s discuss the prostate, current testing methods, the new testing method, and common signs and symptoms that indicate the need for a check-up.

What is the prostate?

The  prostate gland is about the size of a walnut and located just below the bladder in males. It is shaped like a doughnut and surrounds the urethra, the outflow tract from the bladder. That’s why an enlarged prostate often leads to difficulty having a pee, dribbling, urgency, pain or change in the frequency of urination.

Anatomy of the Prostate

There are four disorders that can cause an enlarged prostate:

Prostate cancer is the only potentially life-threatening disease, which is why preventative testing is so important.

Current testing methods: PSA and DRE

Until recently, the Prostate Specific Antigen (PSA) blood test and a Digital Rectal Exam (DRE) were the most effective ways to detect prostate cancer. If abnormalities are found, further testing such as biopsy, is conducted.

The prostate gland makes and secretes proteins called Prostate Specific Antigens into the blood. It is normal for small amounts of PSA to be present in your blood, however when you have prostate disorder (such as the four listed above) the PSA level may rise. The rise is caused by the changing conditions in the prostate gland. So the PSA is specific for the prostate but is not specific for prostate cancer alone. That is, a high PSA does not necessarily indicate the presence of prostate cancer.

A Digital Rectal Exam involves a doctor inserting a gloved and lubricated finger gently into the rectum to feel for the prostate gland. Although uncomfortable for the patient, it will give the doctor the opportunity to physically feel the prostate gland and any anatomical abnormality or inflammation that may be present. Neither the rectal examination nor the PSA blood test are ideal for assessing prostate health. A rectal examination provides a limited assessment of only a small area of the prostate – so it’s not a comprehensive or accurate test of the status of the prostate. The problem, as mentioned previously, is that it’s impossible to feel the whole gland. It’s a bit like doing a breast examination for a woman – but only examining one breast! We usually do a rectal examination now only if you have urinary symptoms that warrant further investigation.

When PSA is floating around in your blood it either attaches to serum proteins (total PSA) or floats around freely (percent free PSA). Comparing the two provides doctors with a way to determine the probability of you having prostate cancer. Used in conjunction with a DRE the doctor will be able to decide if further testing in the form of a biopsy is required.

New testing methods: Prostate Health Index (phi)

Researchers have discovered the precursor forms of PSA. This means we can now identify the isoforms that will develop into PSA, allowing us to monitor these for elevations as well and potentially detect prostate cancer even earlier. A type of percent free PSA, [-2]proPSA has been found to be the best isoform to indicate prostate cancer. The amount of this isoform in your blood is measured by the Access Hybritech p2PSA test. When this test, total PSA and percent free PSA are tested together, the result is called your Prostate Health Index. More accurate than using PSA alone, your phi result will assist your doctor to determine if further tests are needed.

Common signs and symptoms of Prostate disorders:

  • Difficulty in starting to urinate
  • Waking frequently during the night to urinate
  • Sudden need to urinate
  • Slow flow/difficulty in stopping
  • Discomfort when urinating
  • Painful ejaculation
  • Blood in urine or semen
  • Decreased libido
  • Reduced ability to get an erection.

If you suffer from one or more of these symptoms, you should consult your doctor straight away. These symptoms are not a natural part of aging, and need to be investigated to rule out serious conditions such as prostate cancer. Please request an appointment or give us a call on (03) 9642 1377.

How often should I be tested?

Medicare will only cover annual testing for PSA in males aged 50 or older. If you have a family history of prostate cancer it is recommended you begin testing at 40 years. The phi test is not covered by Medicare and is billed privately at a cost of $95.00.

More Information

Feel free to contact us for more information or give us a call on (03) 9642 1377.

For more information, check out the following:
Beckman Coulter Prostate Health Index
Prostate Cancer Foundation of Australia
Australian Prostate Cancer Research

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