The 4Kscore test is a simple blood test that detects high risk, aggressive prostate cancer. It measures four prostate protein (prostate-specific kallikreins) levels in your blood including total PSA, free PSA, intact PSA, and human kallikrein 2 (hK2). The results are combined in an algorithm with patient age.
Why It Is DoneThe prostate-specific antigen (PSA) test is done to:. Screen men for prostate cancer. Since other common medical conditions, such as and prostatitis, can cause high PSA levels, a may be done if your doctor is concerned about signs of prostate cancer. Check if cancer may be present when results from other tests, such as a, are not normal.
A PSA test does not diagnose cancer, but it can be used along with other tests to determine if cancer is present. Watch prostate cancer during or other treatment. If PSA levels increase, the cancer may be growing or spreading. PSA is usually not present in a man who has had his prostate gland removed. A PSA level that rises after prostate removal may mean the cancer has returned or has spread.
How It Is DoneThe health professional taking a sample of your blood will:. Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein. Clean the needle site with alcohol. Put the needle into the vein. More than one needle stick may be needed. Attach a tube to the needle to fill it with blood.
Remove the band from your arm when enough blood is collected. Put a gauze pad or cotton ball over the needle site as the needle is removed. Put pressure on the site and then a bandage. ResultsA prostate-specific antigen (PSA) test measures the amount of in the blood.The normal values listed here—called a reference range—are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what's normal.
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Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab. NormalBecause normal PSA levels seem to increase with age, age-specific ranges may be used. But the use of age-specific ranges is controversial, and some doctors prefer to use one range for all ages.
For this reason, it is important to discuss your test results with your doctor. Total prostate-specific antigen (PSA)Men ages 40–49:0–2.50–2.5Men ages 50–59:0–3.5 ng/mL0–3.5 mcg/LMen ages 60–69:0–5.5 ng/mL0–5.5 mcg/LMen ages 70 and older:0–6.5 ng/mL0–6.5 mcg/LA PSA level within the normal ranges does not mean that prostate cancer is not present. Some men who have prostate cancer have normal PSA levels. High valuesHigh levels do not always mean prostate cancer is present. PSA levels may be high if the prostate gland is enlarged or inflamed.A follow-up test that measures free prostate-specific antigen (free PSA) may be used to see if a prostate biopsy should be done to check for cancer. Free PSA is the percent of prostate-specific antigen that is not attached to proteins in the blood. The lower a man's free PSA percentage, the more likely he is to have prostate cancer.A man with a total PSA between 4 and 10 ng/mL may have a test to find out his free PSA, to see if cancer is likely to be present.
This test can be very useful if he had a negative prostate biopsy in the past but still has a high total PSA. Free prostate-specific antigen (fPSA)Percent of free PSAProbability of cancerMore than 25%:8%20%–25%:16%15%–20%:20%10%–15%:28%0%–10%:56%. What Affects the TestReasons you may not be able to have the test or why the results may not be helpful include:. Recent sexual activity (ejaculation). Recent use of a tube to drain urine or a. Recent or prostatitis.
Recent, prostate biopsy, or prostate surgery. Large doses of medicines, such as cyclophosphamide (Cytoxan) and methotrexate for cancer treatment. The medicines dutasteride (Avodart) and finasteride (Proscar), which are used to prevent further enlargement of the in men who have BPH, or the type of finasteride (Propecia) that is used for male-pattern baldness. What To Think About.
When combined with a digital rectal exam, the prostate-specific antigen (PSA) test may increase the chance of finding prostate cancer. To learn more, see the topic. Experts disagree about the type of testing that is appropriate if the PSA level is high. The decision may depend on:.
Results of your digital rectal exam. Results of any PSA tests you have had in the past. If your PSA level gets higher in a short amount of time, follow-up testing may be recommended. Your age and health. The costs and risks of more tests and treatments. Other prostate tests are being evaluated to determine how well they tell the difference between prostate cancer and benign prostatic hyperplasia.
The prostate-specific antigen density (PSAD) test compares the PSA value to the size of the prostate gland. The size of the prostate is measured using transrectal ultrasound (TRUS).
The PSA velocity test is a measure of how rapidly PSA levels increase over time. PSA levels increase more rapidly in men with prostate cancer and more slowly in men with prostate enlargement (benign prostatic hyperplasia). A complexed prostate-specific antigen (cPSA) test may help show if a prostate biopsy should be done.
This test measures the amount of several forms of PSA that are attached to proteins found in the blood. References Citations. Fischbach FT, Dunning MB III, eds.
Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins. Pagana KD, Pagana TJ (2010).
Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. Louis: Mosby Elsevier.Other Works Consulted.
Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. Louis: Saunders. Fischbach FT, Dunning MB III, eds. Manual of Laboratory and Diagnostic Tests, 8th ed.
Philadelphia: Lippincott Williams and Wilkins. Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. Louis: Mosby Elsevier. U.S.
Preventive Services Task Force (2012). Screening for prostate cancer: Recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/prostatecancerscreening/prostatefinalrs.htm.