phi and 4Kscores equals in predicting upgrades to Gleason 7
Join me in Vancouver via Zoom on June 7.
By Howard Wolinsky
I have monitored my low-risk prostate cancer with the phi (Prostate Health Index) since 2016. PHI looks at three PSA biomarkers. regular PSA, free PSA and free PSA and [-2]proPSA—all types of PSA molecules.
The test gives some indication of my “dark passenger, “my so-called cancer, a minimal Gleason 6, is getting aggressive, whether it’s a sleeping lion or starting to act like a snarling tiger.
So far, so good. (In fact, my phi test fell 25% this year.)
Meanwhile, phi has a competitor, the 4Kscore, with four biomarkers, developed at Memorial Sloan Kettering (MSK) Cancer Center in New York City.
Last weekend at the American Urological Association meeting in New Orleans, researchers from Johns Hopkins in Baltimore, Maryland, and MSK released the results of a head-on comparison of phi and 4Kscore.
Hopkins had a collection of extra blood samples taken for the phi test. The researchers sent experimental samples from the same blood draws to MSK to be tested with the 4Kscore.
Epidemiologist Bruce Trock, PhD, of Johns Hopkins, who presented the study at the American Urological Association (AUA) 2022 Annual Meeting, told Medscape Medical News (me). "The results came out pretty much the same," he added.
The small study looked at how well the tests predicted upgrades to Gleason 7s.
So that’s good news. If we happen to be taking these blood tests, it doesn’t matter which one we get.
phi has one advantage. It looks to be much cheaper than 4Kscore.
Lab at the hospital, where I am followed, lists $554 for a panel that includes regular PSA, free PSA, and phi, offering more data at a lower cost than the 4Kscore, which lists at $760.
I used to cover the tech industry for the Chicago Sun-Times in the early days of the internet. It was not uncommon for companies to have bakeoffs, or the unfortunately named “shootouts” with competitors. It was part of their culture.
It would be great for us patients and our doctors if such bakeoffs were done routinely. They’re not.
I gather manufacturers of molecular tests are not keen on the idea.
Too much at stake to lose? So consumers are subjected to the mushroom treatment—kept in the dark and fed manure.
This time it’s personal. Please spend an evening with me via Zoom talking about being a patient. I have a lot to say, and I want to hear about your experiences.
The Tri-Cities Support Group from outside Vancouver has invited me (TheActiveSurveillor.com) to speak. I will nag you until you sign up. So sign up. Resistance is futile.
No registration necessary. Go to: https://bit.ly/3NGQQob
Here’s what Dale Bryant from Tri-Cities and Richelle Green from ProstateSupport Canada put together:
“Lessons Learned: My Prostate Cancer-and Yours”
JUNE 7TH, 2022 | 7:00 PM Pacific/ 8:00 PM Mountain/ 9:00 PM Central/10:00 PM Eastern
Go to: https://bit.ly/3NGQQob
The Tri-Cities Support Group's speaker will be Howard Wolinsky, a co-founder of Active Surveillance Patients International. Howard is an award-winning medical and science journalist from Chicago, who in his working days, wrote for the Chicago Sun-Times. He recently started writing a newsletter: TheActiveSurveillor.com
Also, I write for Medscape.com and MedPageToday.com
Howard is the author or co-author of three books about medical issues.
Since he has been so willing to speak to people and write about his experience with prostate cancer, he is an ideal choice to introduce the topic of how to talk about prostate cancer to family, friends and those with whom we come in contact. We are hoping that his talk will serve as a springboard for an interesting sharing of information on how comfortable people are to talk about their prostate cancer journey with others.
Simply, go to: https://bit.ly/3NGQQob
More: Two experts who have made big news on lifestyle and prostate cancer will share their research on diet, including plant-based and Mediterranean plus other lifestyle choices, including exercise and sleep, at an AnCan webinar for all patients with prostate cancer 8-9:30 p.m. Eastern on May 31. Register at: https://bit.ly/3KkxcfC
The webinar, entitled “Optimizing Sleep, Exercise, and Nutrition in Prostate Cancer," features Dr. Stacy Loeb, professor of Urology and Population Health at the New York University School of Medicine and the Manhattan Veterans Affairs Medical Center, and Dr. Justin Gregg, assistant professor of Urology and Health Disparities Research at UT MD Anderson Cancer Center, of UT MD Anderson Cancer Center in Houston.
Active Surveillance Patients International and the AnCan Virtual Support Group for AS are teaming up for a program on BPH (benign prostate hyperplasia), an enlarged prostate, a not uncommon problem in patients on AS with intact prostates. Men who have been treated encounter similar issues,
It’s a drop-in First Wednesday meeting, June 1 at 8 p.m. EST. No registration is necessary. Attend the free program, featuring BPH guru, Mount Sinai’s Dr. Steven Kaplan.
Just enter the AnCan Barniskis Room. And bring your questions .... in fact, if you already have something in mind, send it ahead of time to Joe Gallo at joeg@ancan.org.
Also, it is possible to also have BPH with G6? How about prostatitis at same time with G6? If so, then it seems it would be harder to tell if G6 turns to G7 based on PSA alone.
Question, if G6 should not be considered cancer, should we even think about areas of HGPIN on a biopsy?