January 01, 2017
A man’s PSA is higher than it should be. Does he have cancer? Or is it prostatitis, benign enlargement, or another benign problem? The Prostate Health Index (PHI) blood test, measures PSA in several ways: “It measures PSA, percent free PSA, and the PSA isoform -2proPSA,” says urologist Ashley Ross, M.D., Ph.D., “and it reports a calculated score called PHI.” Who might benefit from this test? A man with an elevated PSA who may need a prostate biopsy — but then again, he may not.
PHI has been available at Hopkins for over a year, and Ross, with co-investigators including Jeffrey Tosoian, M.D., and Lori Sokoll, Ph.D., studied the test’s impact on clinical practice. “We found that among doctors using the PHI test, biopsy was recommended 10 percent less frequently,” Ross reports. “Importantly, there was no reduction in the number of significant cancers diagnosed. Instead, biopsies appeared to be spared in the men who previously would have undergone a biopsy that turned out to be negative. We concluded that the PHI, which is inexpensive and simple to obtain, should be used before a prostate biopsy in men with an elevated PSA.”