4K test, and what to advise my 2 sons

[Johnkelsey]

Haven’t seen much about this test, which I had done in April this year in advance of agreeing to a biopsy. It predicted Gleason 9 and 95% chance of prostate cancer, which subsequent biopsy and MRI confirmed as advanced (Dx May 2). I have no idea how reliable this test is, it’s not in general use, but at least in my sample of one it was spot on and impelled me to have the damn biopsy that I had been resisting. I was hoping it would indicate I did not need to worry, hahaha.

The question arises in a more than theoretical way because my dad also had PCa and I have two sons now in their 40s. Their risk is 4x a man who does not have close male relatives with PCa, and I’m grappling with what’s the best advice to hand them now. Annual PSA, sure, pay attention to “trivial” symptoms, but then what, go straight to biopsy, or have the 4K first and build that into the decision process? Anybody with relevant experience/advice?

[pjoshea13]

John,

Some might be troubled by a test that returns a probabilistic result, yet a biopsy is based on only a sample of tissue.

I feel that your sons should begin monitoring PSA, looking out for upward trends. If there is concern, a 4K test could help avoid an unnecessary biopsy & give one more reassurance than a negative biopsy.

I know that a man in this group had a misleading low-risk result, but I have to believe it's the way forward. This year in the U.S., there will be > 650,000 unnecessary biopsies.

-Patrick

[curt504a]

As a base line and then periodic every few years my plan is go straight to the best imagining tactic: 3 tesla MP MRI with contrast.

I wrote up one here: healthunlocked.com/advanced...

This shop and maybe others can do biopsy but guided real time by MRI imaging. Zero guessing or random luck re where the needle goes. For me the image showed clear / clean prostrate no need for biopsy. My PSA had dropped. They took a semen sample and the rising PSA was prostititis. Where more basic practitioners would have poked me a dozen times biopsying all for no gain and potential bad side effects of biopsy proceedure gone bad (infection ++).

True you need to have the $$ for the above. There is value in avoiding biopsing when its not a value.

Short of $2500 every few years I too would like to know a better early detection proceedure:

- PSA + Phosphate test + Albinumin + ?

- what else?

BTW folks should read the albinumin blood test write ups.

[Tall_Allen]

Because insurance doesn't cover it, 4K score costs about $400 out of pocket. There is a very similar test called Prostate Health Index (PHI) which is covered by insurance. They are both equally accurate, so why not go with the cheaper one?

[Johnkelsey in reply to Tall_Allen]

Thanks for the info - my 4K was ordered by a non-Medicare physician, I think it cost about $250. But my sons have regular medical insurance so this is good to know.

[Eabradley in reply to Johnkelsey]

my son was dx at 40 with stage 4 and PSA at 1250. regular dr. refused to Do a PSA test even though my son requested it and his father had prostate cancer at age 65

now we are on the fight to save his life .

my advise is to test early and often before it can spread and when it is curable .

these young lives deserve a chance to live a healthy life

[j-o-h-n]

I tell every adult male I meet to check their PSA. Most look at me with a look of WTF is a PSA. Thank God for this site.

They say that the early worm gets the bird.

Good Luck and Good Health.

j-o-h-n Friday 07/13/2018 9:46 PM EDT

[dadeb]

Not fair at all. All the best hope for you and your son.

Deb 🌷