Urology Case Studies

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 UROLOGY CASE STUDY
Patient: Doug*
Age: 62
*Hypothetical patient profile
History of Present Illness (HPI)
Presents with chief complaint of:
•  Increased urinary frequency
•  Painful urination
Medical History
•  Hyperlipidemia
•  Erectile Dysfunction
•  Negative biopsy 3 years ago
Family History
•  Father diagnosed with prostate cancer
at 64
Test Results
PSA tested annually since age 52.
Scores range from 2.3 – 4.9
  specific biological markers
Most Recent PSA Score: 4.6
 
68
Clinical Assessment
•  Key factors to consider?
•  Severity/duration of
symptoms?
•  Differential diagnosis?
Clinical Decision
•  Change in follow-up/
monitoring?
•  Follow-up labs?
•  Imaging?
•  Biopsy?
risk of prostate cancer.
What is APIFINY®?
APIFINY is the only cancer
specific, non-PSA blood test
that may aid clinicians in the
assessment of risk for the
presence of prostate cancer.
When should I order
APIFINY?
APIFINY may be used in
men who have an elevated
PSA (>2.5 ng/ml) and are
considering a prostate biopsy.
Why should I order
APIFINY?
APIFINY measures certain
that may provide you with
additional insight to aid in
a clinical decision for
determining your patient’s
 UROLOGY CASE STUDY
Patient: George*
Age: 50
*Hypothetical patient profile
History of Present Illness (HPI)
Presents upon referral from primary care:
•  Nocturia (slightly worse over past year)
•  Normal digital rectal exam (DRE)
•  Normal urinalysis (UA)
Medical History
•  Hypertension (HTN)
•  Erectile Dysfunction
Family History
•  Father died of a heart attack at age 60
Test Results
PSA tested annually since age 42.
Scores range from 2.6 – 3.7
  specific biological markers
Most Recent PSA Score: 4.5
 
54
Clinical Assessment
•  Key factors to consider?
•  Severity/duration of
symptoms?
•  Differential diagnosis?
Clinical Decision
•  Change in follow-up/
monitoring?
•  Follow-up labs?
•  Imaging?
•  Biopsy?
risk of prostate cancer.
What is APIFINY®?
APIFINY is the only cancer
specific, non-PSA blood test
that may aid clinicians in the
assessment of risk for the
presence of prostate cancer.
When should I order
APIFINY?
APIFINY may be used in
men who have an elevated
PSA (>2.5 ng/ml) and are
considering a prostate biopsy.
Why should I order
APIFINY?
APIFINY measures certain
that may provide you with
additional insight to aid in
a clinical decision for
determining your patient’s
 UROLOGY CASE STUDY
Patient: Robert*
Age: 45
*Hypothetical patient profile
History of Present Illness (HPI)
Presents for routine annual exam:
•  Mildly enlarged prostate gland
•  Negative review of symptoms (ROS)
Medical History
•  Hypertension (HTN)
•  Vasectomy 5 years ago
•  Negative biopsy 2 years ago
Family History
•  Grandfather diagnosed with prostate
cancer at 54
Test Results
PSA tested annually since age 40.
Scores range from 2.8 – 4.7
  specific biological markers
Most Recent PSA Score: 4.6
 
22
Clinical Assessment
•  Key factors to consider?
•  Severity/duration of
symptoms?
•  Differential diagnosis?
Clinical Decision
•  Change in follow-up/
monitoring?
•  Follow-up labs?
•  Imaging?
•  Biopsy?
risk of prostate cancer.
What is APIFINY®?
APIFINY is the only cancer
specific, non-PSA blood test
that may aid clinicians in the
assessment of risk for the
presence of prostate cancer.
When should I order
APIFINY?
APIFINY may be used in
men who have an elevated
PSA (>2.5 ng/ml) and are
considering a prostate biopsy.
Why should I order
APIFINY?
APIFINY measures certain
that may provide you with
additional insight to aid in
a clinical decision for
determining your patient’s
 UROLOGY CASE STUDY
Patient: Peter*
Age: 55
*Hypothetical patient profile
History of Present Illness (HPI)
Presents upon referral from primary care:
•  Denies any symptoms (negative ROS)
•  Normal urinalysis (UA)
•  Mildly enlarged prostate gland
Medical History
•  Hypertension (HTN)
•  Negative prostate biopsy 5 years prior
Family History
•  No known history of prostate cancer
Test Results
PSA tested annually since age 42.
Scores range from 2.3 – 4.5
  specific biological markers
Most Recent PSA Score: 4.2
 
92
Clinical Assessment
•  Key factors to consider?
•  Severity/duration of
symptoms?
•  Differential diagnosis?
Clinical Decision
•  Change in follow-up/
monitoring?
•  Follow-up labs?
•  Imaging?
•  Biopsy?
risk of prostate cancer.
What is APIFINY®?
APIFINY is the only cancer
specific, non-PSA blood test
that may aid clinicians in the
assessment of risk for the
presence of prostate cancer.
When should I order
APIFINY?
APIFINY may be used in
men who have an elevated
PSA (>2.5 ng/ml) and are
considering a prostate biopsy.
Why should I order
APIFINY?
APIFINY measures certain
that may provide you with
additional insight to aid in
a clinical decision for
determining your patient’s
 APIFINY® – Results Interpretation
APIFINY® Prostate Cancer

0 Lower 59 Higher 100

Risk Risk
Risk Assessment

Lower risk of prostate cancer. Score not consistent with prostate cancer.
“In the most recent peer-reviewed published study on Apifiny1, approximately 9 out of 10 men like you, with a
score of less than 59, were cancer free.”
Potential clinical decision2: Combine with other clinical information to determine next steps.
Continue routine clinical monitoring.

Higher risk of prostate cancer. Score consistent with prostate cancer.

“In the most recent peer-reviewed published study on Apifiny1, approximately 1 out of 3 men like you, with a
score of 59 or above, had prostate cancer. You may be at higher risk.”
Potential clinical decision2: Combine with other clinical information to determine next steps.
Develop an individualized patient management plan and consider a prostate biopsy

1.  Translational Oncology, April 2015, Volume 8 Number 2: 106-111

2.  Physician utilization market research (2015)

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