Which tests should I get, diagnostic, precision tests etc. that might not normally get ordered from the PCP? I want...

For prostate cancer, there are several diagnostic and precision medicine tests that can provide valuable information for treatment planning. While your primary care provider (PCP) may order some initial tests, it's important to work with a urologist or oncologist specializing in prostate cancer for a comprehensive evaluation. According to the NCCN Guidelines for Prostate Cancer (Version 3.2023), the following tests are recommended:

1. PSA (Prostate-Specific Antigen) Test: This blood test measures PSA levels, which can be elevated in prostate cancer. (CPT code: 84153)

2. Digital Rectal Exam (DRE): A physical exam where the doctor feels the prostate for any abnormalities. (CPT code: G0102)

3. Prostate Biopsy: If PSA levels are elevated or the DRE is abnormal, a biopsy may be performed to collect tissue samples for analysis. (CPT codes: 55700, 55705)

4. Imaging Tests: MRI, CT, or bone scans may be used to determine the extent of the cancer. (CPT codes: MRI - 72197, CT - 72192, Bone Scan - 78306)

5. Genetic Testing: The NCCN recommends considering genetic testing for inherited mutations (e.g., BRCA1/2, ATM, CHEK2) in all men with high-risk, very high-risk, regional, or metastatic prostate cancer. (CPT codes: 81162, 81432)

6. Tumor Molecular Testing: Precision medicine tests, such as next-generation sequencing (NGS) or immunohistochemistry (IHC), can identify specific tumor mutations or biomarkers that may guide treatment decisions. The NCCN recommends considering tumor testing for homologous recombination deficiency (HRD) and mismatch repair (MMR) status in certain cases. (CPT codes: NGS - 81445, 81455; IHC - 88341, 88342)

The American Urological Association (AUA) also provides guidelines on the early detection of prostate cancer, emphasizing the importance of shared decision-making between patients and providers regarding PSA testing and biopsy decisions.

Remember to consult with your healthcare team to determine which tests are most appropriate for your individual situation, as not all tests may be necessary or covered by insurance. Your providers can help you navigate the insurance process and provide guidance on the most essential tests for your prostate cancer care.