- Image by psd via Flickr
In our lab we’re setting up the PCA3-test designed to aid prostate cancer diagnostics. The test is representative of many emerging diagnostic tests in that it is a) a supplement to existing testing and b) useful only in a subset of conditions.
The PCA3-test complements results from digital rectal examination, PSA tests, and prostate biopsies. Three tests that until recently have constituted the cornerstones of prostate cancer screening and diagnostics. The relationship between the results from these tests is dynamic and interpretation of test results is often complicated, sometimes very confusing and can, in the worst case, be very uncertain. Add the gene expression results from the PCA3-test and you have a lot of valuable information, but a tough time filtering it into useful clinical information.
Physicians will learn how to combine the information either in med-school or in update learning courses later in their career. A slow and sometimes insufficient way to convey diagnostic information to the clinic, treating physician and ultimately, the patient.
Thankfully, we live in the information age and medicine 2.0 is well underway. Now the doctor or the patient can separately or together get online assistance in interpreting prostate cancer test-results. Well designed and user-friendly calculators like the “Risk of Biopsy Detectable Prostate Cancer” calculator or prostatecancer-riskcalculator.com (professional use) will help anyone undertand and begin to interpret lab-results. A big step forward in my opinion since information flow becomes quick and targeted.
Such calculators have also been made available for cancer risk prediction: nomograms.org, for Marevan/Warfarin dosing: Warfarindosing.org, and as demonstrated in a previous post, for Testosterone: Testosterone.
There are probably a lot of calculators out there that I haven’t found yet and it’s highly likely that many more will be developed.
It seems clear to me that interpretation of clinical lab-results may not remain entirely in the physician domain much longer. Hopefully such automated interpretation will lead to patient empowerment and make deciding on clinical action an easier task.
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BIOpinionated 
Sirs,
despite all numerous laboratory progresses, prostate cancer is a growing epidemics. Clealy there is something wrong in disorder today’s primary preventio. In my 53-year-long well established clinical experience, Massucco’s sign (by the name of my friend-colleague, former GP in my city) proved to be a reliable and useful tool for early bed-side detecting prostate cancer, since its first stage, i.e., cancer Inherited Real Risk, mainly overlooked by phisicians around the world, in individuals obviously with Oncological Terrain, (1-9) (website, http://www.semeioticabiofisica.it, Oncological Terrain).
In health, lying down on supine position, psycho-physically relaxed, and with open eyes to avoid endogenous melatonin secretion, lasting cutaneous pinch of XI thoracic dermatomere, at right or left, i.e., prostate trigger-points (= diverse groin regions trigger-points), brings about aspecific gastric reflex (= stomach fundus and body dilate, while antral-pyloric region contracts), after a latency time of exactly 8 sec. (1-9).
The reflex lasts physiologically “less” than 4 sec. (= normal Microcirculatory Functional Reserve; it’s really a paramount parameter value, since it parallels fractal dimension of related microvessell fluctuations, as well as Microcirculatory Functional Reserve) and then disappears for > 3 3 < 4 sec.), and finally stomach contracts "pathologically" a typical way: tonic Gastric Contraction (tGC), physiologically absent.
These parameter values, related to the severity of underlying malignancy, in every tissue, indicate prostatic microcirculatory abnormalities, so-called “microcirculatory remodelling”, based on newborn-pathological, type I, subtype a), oncological, Endoarteriolar Blocking Devices, I discovered (1-9). More precisely speaking, lt. becomes shorter than the normal 8 sec. in inverse relation to the tumour invasion. In day-to-day practice, biophysical semeiotic prostate "preconditioning" is very useful and reliable: exactly 5 sec. after the basal carrying out, when prostatic Microcirculatory Functional Reserve is activated, doctor performs the described manoeuvre a second time.
Iin health, where tonic Gastric Contraction is always absent, all parameters values improve in a clear-cut manner: latency time raises to 16 sec., i.e., doubled value
On the contrary, they either persist unchanged or increase not significantly in relation to the severity of prostate inherited cancer “real risk”. Finally latency time worsens in a clear-cut manner in case of overt prostate cancer, since initial stages of its evolution. Massucco’s sign, easy to perform and reliable at the bed-side, is really useful in both prostate cancer clinical screening and diagnosis, among a large variety of other remarkable biophysical-semeiotic signs. In addition, as I described previously (2-8), malignancies occur on the base of a genetically transmitted mitochondrial cytopathology, I named Congenital Acidosic Enzyme-Metabolic Histangiopathy, conditio sine qua non of Oncological Terrain. Such as inherited abnormalities of psycho-neuro-endocrine-immunological system is almost in all cases transmitted by mother. Therefore, it is non-sense, or at least useless, for instance, to ask a patient’s father wether or not is, or was, involved by prostate cancer, as well as assess PSA and newly discovered mutated genes level in men without Oncological Terrain and/or Prostate Cancer Real Risk.
1) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004. http://www.travelfactory.it
2) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz. Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28 Settembre-1 Ottobre 1983, Bellagio.
3) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, 1981, Siena
4) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Una Patologia Mitocondriale Ignorata. Gazz Med. It. – Arch. Sci. Med. 144, 423, 1985 (Infotrieve).
5) Stagnaro-Neri M., Stagnaro S., Cancro della mammella: prevenzione primaria e diagnosi precoce con la percussione ascoltata. Gazz. Med. It. – Arch. Sc. Med. 152, 447, 1993.
6) Stagnaro Sergio. Bed-Side Prostate Cancer Detecting, even in early stages (“Real Risk” of Cancer): BMC Family Practice, 2005, 6:24 doi:10.1186/1471-2296-6-24 http://www.biomedcentral.com/1471-2296/6/24/comments#202466
7) Sergio Stagnaro Mitochondrial Bed-Side Evaluation: a new Way in the War against Cancer (21 December 2005). Cancer Cell International http://www.cancerci.com/content/5/1/34/comments#218502
8) Stagnaro Sergio. Teoria Patogenetica Unificata, 2006, Ed. Travel Factory, Roma
9) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, http://www.travelfactory.it, Roma, Luglio 2009.