HGPIN, PCA3, Boston Uros

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New Member

Date Joined Mar 2010
Total Posts : 8
   Posted 4/30/2011 8:53 AM (GMT -6)   
My bf just received first biopsy results - 11 cores negative, 1 core had HGPIN. The uro has recommended another biopsy within 3 months.

The uro said if they don't find anything on the second biopsy, and assuming the PSA continues its upward trend, then we'll be riding the biopsy merry-go-round until they find PC. The general advice we've been given is that HGPIN is considered a precancerous legion, and that occult PC is generally assumed.

Does anyone know if PCA3 assays are useful in predicting biopsy outcomes in patients with isloated HGPIN?

Until we get results from a second biopsy this may be a moot question - but our goal in asking is to understand if PCA3 testing could potentially provide a marker toward future biopsy outcomes, and potentially reduce the number of biopsies on the merry-go-round.

One challenge we have is that the specialist we've been dealing with doesn't consider PCA3 as "standard care", and won't discuss the test at all, nor order it. Obviously we need to find another specialist who is more up on the latest technologies. Does anyone know of any good uros in the Boston area who are a little more current and flexible? Maybe someone at Mass General? We've seen that Mass Gen is ranked #12 in the country for PC care.

Thanks in advance for any replies/info.


New Member

Date Joined Mar 2010
Total Posts : 8
   Posted 4/30/2011 8:53 AM (GMT -6)   
Sorry meant to include scores...
Age 43

1/2008 PSA 2.8
1/2009 PSA 2.8
3/2010 PSA
3/2010 Free PSA 11%
2/2011 PSA 5.4
2/2011 Free PSA 9%
4/2011 PSA 8.5

4/2011 Biopsy - 11 cores negative, 1 core HGPIN

Normal DREs for all years

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4171
   Posted 4/30/2011 10:08 AM (GMT -6)   
You are basically on an Active Survelience program from now on. I don't think that PCA3 would be useful in eliminating a biopsy, but it would be useful to get as it gives another baseline, much like psa, in monitoring progression and may give an indication of agressiveness.
You may also want to look into having a color doppler ultrasound as it will give a very good baseline and could eliminate some future biopsies.
Your bf's psa velocity is very high and is a concern so a 2nd biopsy in a couple of months is warrented.
Also have your uro calculate his psa density as he has the size of his prostate from his ultrasound. psa density = psa divided by(prostate size X .1) . psa density should be less than 1.5.
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

New Member

Date Joined Sep 2010
Total Posts : 9
   Posted 5/1/2011 10:49 AM (GMT -6)   
My understanding is that PCA3 is often elevated with HGPIN.

Veteran Member

Date Joined Jul 2010
Total Posts : 3596
   Posted 5/1/2011 3:09 PM (GMT -6)   
There ARE genetic urine tests in existence that can verify the presence of cancer with great accuracy.. However, getting one performed is very difficult as they are not being marketed at this time in the United States.

One, the "Four Gene Signature Urine Test" has been licensed to both Abbott labs and Quest labs and they are both just sitting on it....

Now that the location of the PIN cells is known, you can be sure the next biopsy will focus on this area..That's how mine was found on the thrid try...
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

Regular Member

Date Joined Sep 2010
Total Posts : 309
   Posted 5/1/2011 4:30 PM (GMT -6)   
Lisa, I don't want to pretend to be an expert on the issue, but the PCA3 test was useful to us. My husband had already had one negative biopsy and his PSA had risen again. His urologist recommended another biopsy, but not strongly. I think my husband was prepared to refuse the second biopsy until the PCA3 test result indicated a likelihood of malignancy. The second biopsy found both HGPIN and cancer in one core.

Insurance did pay for the test in his case, so you might want to look into that...

Good luck.


New Member

Date Joined Feb 2011
Total Posts : 5
   Posted 5/1/2011 4:50 PM (GMT -6)   
After considering doctors around the country we decided on Dr. McGovern at Mass General.  We waited longer
so he could do the biopsy.  He is an excellent doctor and performed my husbands surgery 3 weeks ago.
Good Luck
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