Other Tests for Prostate Cancer

Genetic testing may show if you have certain gene changes or mutations that can be passed down in families that increase the risk of prostate cancer. Testing usually involves taking a small sample of blood or saliva. Your results may help your family members decide if they should get tested too. If you have certain mutations and have already been diagnosed with prostate cancer, you may be a candidate for targeted therapy.

The Prostate Cancer Genetics Clinic at Fred Hutch offers genetic testing for men already diagnosed with prostate cancer who have metastatic disease or certain risk factors. People with any stage of prostate cancer can find out if they have an inherited mutation by participating in the PROMISE study. PROMISE stands for Prostate Cancer Registry of Outcomes and Germline Mutations for Improved Survival and Treatment Effectiveness.

MRI makes detailed pictures of the soft tissues inside your body using radio waves, a powerful magnet and a computer. Multiparametric MRI (mpMRI) is a specialized MRI scan of your prostate.

Your physician might use mpMRI to help decide if you should have a prostate biopsy. It’s possible to have a normal MRI but still have prostate cancer. So, physicians often do biopsies even when MRI results appear normal. They can also use mpMRI to find areas that look suspicious so they can target these areas during a biopsy, a method called MRI-fusion biopsy. Usually, physicians do this if your earlier biopsy did not show cancer, but your PSA level is rising or causing ongoing concern.

If you’ve been diagnosed with prostate cancer, you might have an MRI of your pelvis to check for cancer spread.

A urinary PCA3 test is a urine test for proteins specific to prostate cancer. If your total PSA is high or abnormal, your physician might use this test to decide if you need a biopsy. Unlike PSA, PCA3 is made only by prostate cancer cells. The level is not affected by your prostate size. This test can be used along with total PSA and free PSA tests. A free PSA test checks the amount of PSA in your blood that is not bound to other proteins. This is a subset of your total PSA.

Physicians use urinary PCA3 tests more often in men whose biopsy did not show cancer to decide if they should have another biopsy.

A bone scan (bone scintigraphy) is an imaging procedure. It can show abnormal spots in the bones. Before the scan, you’ll get an injection of a small amount of radioactive material. This travels through your bloodstream and collects in your bones. The scanner detects the radioactive material. If you’ve been diagnosed with prostate cancer, you might have a bone scan to see if the cancer has spread to your bones. A bone scan can show other conditions, like arthritis, too. So, you might need other imaging or biopsies as well.

A PET scan is another type of imaging procedure. It’s similar to a bone scan. You get an injection of a small amount of radioactive glucose that travels through your blood. In this case, the material collects mainly in cancer cells. The scanner makes a picture of where it is collected.

Many centers, including Fred Hutch, are using new types of PET scans. We offer prostate-specific membrane antigen (PSMA) PET. It’s considered the most sensitive way to detect prostate cancer. We also have an imaging test called Axumin PET. Before the scan, you get an injection of fluciclovine F 18, a radioactive agent that tends to collect in areas with cancer activity. These areas then light up on your scan.

PET scans are a way to detect cancer that has spread. If your cancer has spread, it may affect your treatment options. It may also make you eligible for clinical trials.

A CT scanner uses X-rays and a computer to make 3-dimensional pictures of tissues and organs in your body. If you’ve been diagnosed with prostate cancer, you might have a CT scan of your abdomen or pelvis to check for cancer spread.