Will the Prostate Cancer 4Kscore Test Help You?

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blood testWill the Prostate Cancer 4Kscore Test Help You?

The Takeaway First

The newest available blood test, 4Kscore® Test (OPKO Lab, Nashville, TN) is better at detecting potential deadly prostate cancer than a PSA test.

The Details

Since the prostate-specific antigen (PSA) test first became available in the early ‘90s, there have been significantly fewer deaths from prostate cancer. However, it also has led to overdiagnosis and overtreatment. As a result, about one million prostate biopsies are done yearly in the U.S. alone, and most of it has been from unnecessary overtreatment of indolent cancer in order to rule out the possibility of death.

Numerous studies from Europe and the U.S. indicate that the 4Kscore could be used to distinguish between the less deadly form of prostate cancer (pathologically indolent, as a doctor calls it) and the more dangerous form of the disease — all while reducing excess biopsies.

If that’s true, I’m a fan.

How does the 4Kscore test work? 

The 4Kscore test is a blood test and incorporates a panel of four — buckle your seatbelts — kallikrein protein biomarkers: total PSA, free PSA, intact PSA, and human kallikrein-related peptidase. It looks at these biomarkers as well as other clinical information and provides a percentage risk for high-grade (Gleason score 7 or higher) cancer on biopsy.

In 10 peer-reviewed studies, the four kallikrein biomarkers of the 4Kscore Test have been shown to improve the prediction not only of biopsy accuracy, but also surgical pathology and occurrence of aggressive, metastatic disease.

Instead of a PSA-style range value of normalcy, the 4Kscore result is a percentage with personalized positive predictive value of finding Gleason score ≥ 7 cancer on a subsequent biopsy. This is key because the PSA “normal range” value of 0 to 4.0 ng/ml is extremely inaccurate. I see many patients with a PSA higher than 4.0 without prostate cancer and undergoing excessive prostate biopsies.

How does the 4Kscore compare to the urine PCA3 test?

The PCA3 test looks at a urine sample produced immediately after a vigorous prostatic massage. PCA3 is a gene that expresses genetic material in urine. This material is found only in prostate tumor tissue, not normal prostate tissue.

The problem with the PCA3 test is that the results can be difficult to interpret, partly due to lack of an optimal cutoff for a positive test result. The other issue is that the PCA3 is that there’s not a lot of evidence that it actually helps to detect disease. So, while a reading higher than 35 on a PCA3 test may mean prostate cancer is present, a reading of 100 does not necessarily mean that the cancer is aggressive or deadly. In other words, a higher number does not necessarily mean bad cancer.

Remember: a man is only interested on knowing if he has bad cancer that may eventually kill him – not cancer that’s indolent and non-threatening.

Should I get a 4Kscore test?

No, if you:

  • have been diagnosed with prostate cancer
  • are taking 5-alpha reductase inhibitors like Finesteride (Proscar) or Dutesteride (Avodart)
  • have undergone a prostate procedure within 6 months, e.g., TURP for prostate enlargement

Yes, if you are an otherwise healthy, risk-averse man. The 4Kscore test allows you to gauge your risk and decide, based on reliable, personalized results, whether or not to pursue a biopsy. The level of individualized risk prediction afforded by the 4Kscore test is not only helpful to the patient but also to the urologist (me!), who shares in the patient’s decision making.

My take on the 4Kscore Test for Prostate Cancer

Thumbs up. (Where’s my emoji thumbs-up button?)

Anything that helps to prevent unnecessary procedure and helps the patient make an informed decision is fine by me.

Not only do we now have a test superior to the PSA and even PCA3, but when a biopsy is necessary, we can do a targeted biopsy, which is available in many institutions. This helps to detect only bad cancer cells.

References

Ankerst DP, Hoefler J, Bock S, et al. Prostate Cancer Prevention Trial risk calculator 2.0 for the prediction of low- vs high-grade prostate cancer. Urology. 2014;83:1362–1367.

Vickers AJ, Gupta A, Savage CJ, et al. A panel of kallikrein marker predicts prostate cancer in a large, population-based cohort followed for 15 years without screening. Cancer Epidemiol Biomarkers Prev. 2011;20:255–261

Useful Links:

OPKO Labs

Reviews In Urology

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by Dr. Geo

48 comments… add one
  • BOb Dellacona 11/03/2015, 7:04 PM

    Thanks for a great piece of information Dr. Geo. I’m confused about one point – you say one should not get this test if one is already diagnosed with PCA. I was diagnosed almost 7 years ago – psa then of 6 with a gleason of 7 ( 4 and 3). I was told I was a poor risk for watchful waiting. My psa is now 28. I’m for the most part symptom free. I have been doing watching waiting all of this time. I have not had surgery or radiation or any other radical Western treatments. I would find it valuable to know if my particular prostate cancer is aggressive and would like to take this test. If there is a test that can determine if my cancer is indolent or aggressive, I would really like to know this information. If it’s indolent, I can begin the awesome task of getting cancer out of my mind. If I will most likely die of this cancer and sooner rather than later, I most certainly want to know this. So there you have it – now why shouldn’t I get this test?

    Reply
    • Dr. Geo 11/04/2015, 10:14 AM

      The 4K Score would not be useful to you , Bob, because we already know you have a gleason 7 – so the result would show a high percentage (or a high probability) of having a gleason 7 or higher , which we already know you do. It would not tell us much more than that.

      Reply
  • Wallace Dickson 11/03/2015, 7:11 PM

    This is great news, Dr. Geo. I have been confronted with a “probable” prostate cancer diagnose by my Urologist at the VA Medical Center, based upon a high PSA score. But I have no symptoms, other than an enlarged prostate. The urologist’s assistant did a DPE and reported that he found it “smooth and firm with no irregularities.” I have nocturnal urination issues, but that is all; no pain, no other symptoms. I have had a progressively enlarged prostate since 1984, and have been self-treating it basically with Saw Palmetto and Stinging Nettle. Of late I have added other nutritional protocols as well. So I refused his urging for a biopsy, considering I did not want traditional treatment anyway. No chemo, no radiation, no surgery! I’m chewing on apricot seeds, and following the Budwig Protocol (for the past 8 years).
    So this new non-intrusive test is welcome if it will give me a more definitive assay of prostate cancer, if in fact there is any there. Thanks for reporting on this development!

    Reply
    • Dr. Geo 11/04/2015, 10:10 AM

      Thanks for that report, Wallace. Look out for my book coming out in three weeks- Thrive Don’t Only Survive – its a prostate cancer lifestyle book that will keep you well beyond prostate cancer.

      Reply
  • Robert Toth 11/03/2015, 7:13 PM

    What about testing for recurrence after a 10 year radical prostectomy ?

    Reply
    • Dr. Geo 11/04/2015, 10:08 AM

      After prostate cancer treatment, the PSA is actually very useful. There are other genetic tests, like Decipher from GenomeDx that is available to assess the possibility of metastasis in 3 to 5 years. But if your treatment was 10 years ago then the best method to determine recurrence is PSA.

      Reply
  • Ron Allen 11/04/2015, 8:36 AM

    Why can’t this test be used to predict more aggressive prostate cancer? As you know, I do have PC but would like to know how aggressive it is. Is there a test other than a biopsy that will show this?

    Reply
    • Dr. Geo 11/04/2015, 10:04 AM

      Without a biopsy there is no good way of assessing the “aggressivity” of prostate cancer at this time after diagnosis.
      MRI, PSA velocity are still useful.

      Reply
  • Donald Noone 11/04/2015, 8:47 AM

    Dr. Geo,

    I have had my prostate removed and on subsequent PSA tests in the past couple of years found no detectable signs of disease. Since I want to be sure of no metastasis, should my next PSA be a 4K Score Test?

    Reply
    • Dr. Geo 11/04/2015, 10:01 AM

      Hi Donald, the 4K Score test is only beneficial for men who have NOT had prostate cancer. It is a good screening to tool for such patient. The PSA test is actually a very good test for men after prostate cancer treatment to assess recurrence of cancer.

      Reply
  • Robert Chemtob 11/04/2015, 11:49 PM

    HI
    I’m 62 with a PSA of 4.2 but a free PH of 5.7%. I saw the doctor today and he did a DR3 adn found it to be normal,and said my prostate was a little small.
    He did want to rush me into a biopsy,(which he’ll do) and when I suggested doing a blood test he said that would be done after the biopsy.
    I’m a bit dubious of doing the biopsy, wondering why I can’t first do an MRI to see if any tumor is present? What do you think?
    thanks
    Robert

    Reply
    • Dr. Geo 11/16/2015, 3:24 PM

      Hi Robert, I am not sure why your practitioner would want to do a biopsy before an MRI – it sounds counter-intuitive. He may not have access to a pelvic MRI or able to do a targeted biopsy. I am just speculating. I would suggest an MRI first then a targeted biopsy – if a biopsy is what you have to do. Good luck.

      Reply
      • Robert 12/01/2015, 5:03 PM

        Thank you. I did the MRI then a biopsy which showed 2 tumors of Gleason 6 and 7.
        Going to speak to urologist Friday.

        Reply
        • Dr. Geo 12/01/2015, 5:25 PM

          I don’t know the details of your situation, Robert, but visit with at least 3 urologist before making a final decision on treatment. Let me know if I can help in anyway as I am a prostate cancer navigator with newly diagnosed patients. Good luck.

          Reply
  • Jim Ahearn 07/13/2016, 12:03 PM

    Dr. Geo,

    I am a 69 year old patient with a PSA of 4.2 and a 4K score of 33% (high risk) and a slightly enlarged prostate. Over a two year period, my PSA has elevated from 2.5 to 3.1 to its current 4.2. I also have a 65 year old brother who is a prostate cancer survivor of more than 5 years. Based on this evidence, my urologist is recommending a prostate biopsy. Without any symptoms or problems, I am hesitant to have this procedure. What would be your recommendation? Thank you.

    Reply
    • Dr. Geo 08/25/2016, 10:40 AM

      If you are a robust, healthy 69-year-old, a biopsy might be the way to go. However, I do understand the undesirability of avoiding a prostate biopsy – its no fun, possible risk of infection and blood in your urine and semen. If you do not undergo a prostate biopsy, there will always be some uncertainty as to whether or not you have prostate cancer – you may or may not be OK with that uncertainty. I hope my response helps, Jim.

      Reply
  • Michael 07/26/2016, 6:23 PM

    I have had are cent PSA of 1.6, with a negative DRE. One year ago it was a PSA of .6. I take Dutasteride once a day. In 2010, the PSA was .5, and in 2011 it went up to 1.6. It went back down to 1.2, then 1.1, then 1.0.
    I am concerned because my older brother had prostate cancer, with a Gleason 3 plus 4.
    I am planning to take the 4K test soon. Any thoughts on this would be welcome.
    I have taken prophecies for many years, and just started Avodart seven months ago.

    Reply
    • Dr. Geo 08/25/2016, 10:36 AM

      Avodart may falsely reduce your PSA by 50%. The 4 K score should help determine possible cancer in your prostate. Pelvic MRI is also helpful.

      Reply
  • Jim 12/23/2016, 4:01 PM

    if you take a 4K score test and the reults say you have a 95% chance of developing prostate cancer does this maen I have prostate cancer already??? I would really like to know exactly what this means?? please..

    Reply
  • Francois 01/20/2017, 9:02 PM

    Dear Doctor,
    I had a prostate biopsy in April 2016, result negative. DRE showed little nodule.
    My urologist suggested a 4 k score test, but I am taking Proscar 5 mg, once a day.
    Questions
    1. DO I NEED to stop taking Proscar 6 months BEFORE date of blood draw for 4k score test? And
    2. What other RESTRICTIONS I should follow before blood draw date?
    Thank you Sir,

    Reply
    • Dr. Geo 01/26/2017, 5:07 PM

      The main restriction is stopping Proscar. I do not know of another.

      Reply
  • Martin Silver 02/22/2017, 4:10 PM

    i am a vigorous athletic 77-year-old, latest PSA 2.38; 4K –22%.
    Should I have a Prostate Biopsy now?

    Reply
    • Dr. Geo 02/28/2017, 7:06 AM

      I cannot play doctor on the internet but I can make a suggestion. At 77 years-old and with a low PSA relatively to your age, I think you can avoid a biopsy – particularly at your age. The physical exam (DRE) by your physician can also determine if you should do a biopsy or not.

      Reply
  • James 03/16/2017, 9:13 AM

    I recently had a 4K score done. The doctor told me I should do this test since my P S A is 6.3.
    I am 61 and the 4 K score was 7. His nurse call me to tell the 4K score number. What does the 4K score mean? Thanks James

    Reply
  • paul 04/22/2017, 7:32 AM

    How does finesteride for alopercia affect the evaluation of the 4K score.
    My urologist says it does not.

    Reply
    • Dr. Geo 04/22/2017, 5:11 PM

      It does not effect the 4K score.

      Reply
  • paul 04/22/2017, 7:42 AM

    psa has been < .1 for 15 years straight never changed
    been on finesteride for alopercia 1 mg. for 15 years
    age 72
    never had any prostate symptoms
    never been to a urologist until this week.
    he found 1 mm nodule on 1 side of prostate.
    suggested a 4K score since I did not want any biopsy.
    Said that 4K score is not affected by my finesteride use.
    lab slip says you shouldn't be on finestride but he has done test on hundreds of people on finesteride for alopecia and does not matter for interpretation of results.

    Reply
  • Rick 05/23/2017, 5:51 PM

    Want to ask Dr. Geo about my own experience.
    I recently had my annual checkup with my Urologist. I am 58 years old and have been injecting Testosterone Cypionate for about four years and rubbed Testosterone Gel into my shoulders for two years before that. I was diagnosed with Low T when I was approximately 50 years old.

    In my recent check-up, my Urologist wanted to check my prostate – something she had not done for two years. After her exam, she indicated that she felt a “small nodule” and wanted to schedule a biopsy. I noted that my PSA test (obtained the day before) was only 1.2. She agreed that it was low, but she insisted that I schedule a biopsy procedure with her. I did not schedule immediately – told her I want to wait until later this summer. After returning home that day, I browsed the internet and found the 4K Score Test. I called the manufacturer and spoke with an on staff physician. Although he noted that he could not assess me (over the phone), he indicated that I was a perfect example of someone who should get the 4K Score Exam. I called my Urologist later that week and told her I had found out about the 4K Score Test. She replied that she knew about it and could write a script for me, but that she didn’t think the 4K Score test was reliable – that only a biopsy could determine if my “small nodule” was at risk. She did not mention a “pelvic MRI” which, I read about on your website. I called her office back and asked the office manager to have her write me a script for the 4K Score test. The Dr called me back later in the day, but I was unavailable. I “kinda” feel she is delaying getting that script to me. To refer back to her exam, she said the nodule was small, and that a biopsy was the only way to determine. With a PSA of only 1.2, I feel the 4K Score would be better for me. And then if needed, I would consider a Pelvic MRI before a biopsy. Why do I get the feeling from my physician that she only wants to do a biopsy?

    Thx in advance for your reply.

    Rick

    Reply
  • Rick 05/25/2017, 9:00 PM

    Follow up to my previous post…
    My Urologist has written a script for the 4K Score test. However, after she scolded me asking me what I thought I was going to get. I couldn’t believe it! I wasn’t questioning her judgment, I just wanted to take this exam and then determine what I should do next. Again, she was very reluctant, but in the end told me I could pick up the script. Picking up tomorrow.
    Also, as a follow-up, I’ve read additional information and literature about Pelvic MRIs. Why would I not get a Pelvic MRI before a biopsy? My Urologist, despite my low PSA score (1.2), insists that I come in for the biopsy. I don’t want a biopsy! Especially if the 4K Score test results indicate that I’m not at high risk and if I can obtain a Pelvic MRI instead. Am I wrong? Why the push for the biopsy?

    Reply
    • Dr. Geo 06/18/2017, 8:27 AM

      I am not sure why your urologist wanted to biopsy you with a low PSA. Maybe she felt an abnormality on your prostate…
      Biopsies without MRI are barbaric these days. MRI help to better target the areas of interest,

      Reply
  • Joseph Cavano 05/28/2017, 1:54 AM

    Two questions:

    Since a PSA test cannot determine if a high psa number
    is due to BPH or cancer, would it not follow that the 4K test which relies upon a psa number for one of its markers would be similarly flawed. (As an aside I wonder if there has ever been a study done to check how many people with a 4K over 20 are actually found to have aggressive cancer. If the answer is almost everyone , then the 4K itself may be as invalid for determining cancer as the Psa.
    My statistics: I am seventy four years of age, in exceptionally good health and only within the last two years have I had a psa over four… last two 5.2 and 8.2(4K test for the latter psa number). Digital rectal exam normal.
    Is it likely that I would get an aggressive cancer so late in life . Even if I did,is not true that an aggressive cancer is one that looks much less like a normal cell under a microscope but may in fact be slow to metastasize.
    Finally, if any of the above postulations is true , why should one in my position treat my potential cancer at all.
    Thanks for all you do.

    Reply
  • joseph Cavano 08/27/2017, 11:59 PM

    Here is my reply to my own comment above.

    TO ALL WHO HAVE BEEN TOLD TO HAVE A PROSTATE BIOPSY:

    TAKE YOUR TIME, GET AT LEAST THREE OTHER OPINIONS, AND READ ALL YOU CAN ABOUT PROSTATE CANCER. THERE IS SELDOM ANY RUSH.
    IF YOU ARE SEVENTY OR OLDER BE PARTICULARLY CAREFUL ABOUT BEING PERSUADED TO HAVE THE BIOPSY. PSA IS NOTORIOUSLY UNRELIABLE AND CANNOT DISTINGUISH BETWEEN A RAISED PSA DUE TO CANCER OR BPA WHICH IS AN ACCEPTABLE CONCOMITANT OF AGING. ALSO, MANY SELF-STYLED BREAKTHROUGH TESTS LIKE THE 4K ARE NEARLY AS UNRELIABLE, SINCE THEY TOO RELY UPON FREE AND BOUND PSA IN DETERMINING THE PERCENT RISK ONE HAS OF HAVING AGRESSIVE CANCER.

    MY FORTITUDE PAID OFF. AFTER ABOUT THREE MONTHS OF STUDY AND SECOND OPINIONS ( AND MUCH WORRY AND ANXIETY) I DECIDED TO HAVE AN MRI. IT CAME BACK TOTALLY NEGATIVE FOR CANCER. THE MAJORITY OF SUCH TESTS DO.
    AT THE VERY LEAST HAVE YOURSELF TESTED AT A UNIVERSITY OR TEACHING HOSPITAL.IF YOU HAVE A FRIEND OR RELATIVE WHO IS A DOCTOR ASK HIM IF HE DOES NOT AGREE WITH MY ADVICE. I AM CONFIDENT MOST OF YOU WILL END UP SPARING YOURSELF A PAINFUL AND VERY POTENTIALLY HARMFUL EXPERIENCE.

    Reply
    • Dr. Geo 09/16/2017, 10:26 AM

      Thank you for your comment, Joseph

      Reply
  • Rex Tipton 10/09/2017, 6:13 PM

    Hello,
    I am 52, went for normal physical examine, General Physician found a small nodule on my prostate. He sent me to urologist to have a biopsy but the Urologist stated to do the 4Kscore blood test. They called me back several days later said 4Kscore looked good he didn’t recommend a biopsy and to come back in six months. Reported this back to my regular doctor and he insisted I have a biopsy and referred me to another Urologist, which I haven’t went to. Should have a biopsy are wait and go back in six months. I am not having any issues.

    Reply
    • Dr. Geo 12/04/2017, 2:11 PM

      Hi Rex, what did you decide on. Let me know if you have any questions at this point.

      Reply
  • Jason 01/08/2018, 11:07 PM

    Dr Geo,
    Thank you for taking the interest as you do in all of us men. I’m 63, 6′ , 170lbs and in very good health overall. I’ve been a vegetarian over the past 7 years and do not take any prescription drugs whatsoever, only good vitamins along with zinc and saw palmetto, etc. Over the past 20 years my PSA has been all over the board from around 2 to 12 and everywhere in between ( I think my average is 5-10). 10 years ago I did succumb a biopsy at a University Hospital, along with zero bed side manner … it was a bad experience. Had to call for results (no cancer). BPH only. Since I had had a bout with Hairy Cell Leukemia 15 years ago, and my then 78 year old father was diagnosed with prostate cancer I was and am aware. Concerned but not worried I’ve recently had to apply for certain Life Insurance and as a result had to revisit the prostate cancer potential. Most insurance companies have passed, though not all. My urologist did a DRE with a “normal” result. He then mentioned another test (MDX urine genome test) and I thought, why not give it a go. That result indicated a 43% chance of some cancer, He suggested a biopsy and I needed time to consider that option. Routine for him, not for me. Meantime I learned about the Prostate Health Index (PMI) test and additionally now the K4 test. These two being based on blood chemistry not urine. I’ve opted to have both tests done prior to making a decision on the biopsy. Then there is the Ketogenic diet too. And I have heard that if indeed there is cancer in the prostate a biopsy can potentially release that cancer to go elsewhere. I welcome your thoughts and comments. Thank you very much Dr. Geo

    Reply
    • Dr. Geo 01/15/2018, 8:08 AM

      Hi Jason, Prostate and PSA are likely an area where men are most emotionally connected to. Although I do not (and would not) play doctor on the internet, what you need here sound like a Confirm MDX test which is not a urine test – they take a snippet of our prostate biopsy tissue and genetically analyze it to assure that you do not have prostate cancer that might have been missed. The urine test, SelectMDX is done before a biopsy is performed to see if you need a biopsy in the first place. Before you turn 70 years old you may need another biopsy since you have a paternal family history. Still, eat well take quality supplements and exercise and you will significantly reduce your chances of prostate cancer despite your family history. I hope this helps.

      Reply
  • bill 02/07/2018, 8:37 PM

    Hi Dr. Geo

    I am a 40-year-old male who had been on TRT for 6 years. I had very low test levels do to using steroids in my early 20’s. I permanently damaged my test levels. My TRT has been monitored by a number of Dr’s over the years. The only record I could find measuring my most recent PSA was at 37 years old. My PSA was a 1.79 and my urologist at the time never brought anything up about it.

    I recently moved and started working with a new urologist. He examined my prostate and everything felt fine. I started TRT with him. He did not look at any of my labs until about 6 months into our Dr/Patient relationship. He went back and looked at all of my labs and reviewed my PSA.

    04/01/2017 PSA 2.67
    07/01/2017 PSA 2
    10/01/2017 PSA 2.25

    He wanted to schedule me for a biopsy right there in which I declined.

    I got a second opinion. On this lab, my PSA was a 2.37 and during his exam, he stated I was enlarged but my prostate was smooth. He suggested biopsy and I declined. I agreed to come off testosterone. This Dr’s knowledge on testosterone was very limited. So I ended up finding a Urologist who was well versed in TRT.

    I had labs done prior to my first appointment. I had been off testosterone for 7 weeks at that time. My PSA was a 3.25. He examined me and thought everything felt fine. He drew blood order a PSA and 4k examine.

    My PSA came down to 2.67 and said because of my age I was within range and declined a 4k examine. He suggested I stay off TRT and measure again in a month.

    No one in my family has prostate cancer. All of this has been very annoying and its mind-boggling two Dr’s wanted me to go right to biopsy and not a mention of the 4k blood test. Am I taking the right precautions?

    Reply
    • Dr. Geo 02/08/2018, 11:43 AM

      Bill, if I understand your description properly, your approach to hold off on biopsy is resonable. However, to be super sure I would do a 4k score. There is a small possibility that a guy in his forties may have prostate cancer worth finding (lower grade prostate cancer is not worth finding as they are often indolent). The 4k can provide more peace of mind if the results are negative – thus I would recommend it. Good luck.

      Reply
      • Bill 02/09/2018, 11:56 PM

        Thanks for the response. Sorry, I should have been clearer.The company who tests and gives the 4k results (as per the Urologist) denied my request for the test. They are saying a PSA of 2.67 at 40 years old does not require further testing.

        I was really frustrated because I was hoping this test would give me some answers!

        Reply
  • Larry Deschaine 02/20/2018, 5:57 PM

    I am 69 years old and have had a large prostate for as long as I can remember. I have had 2 biopsies (3 years apart), the last one being about 2 yrs ago and now my doctor wants me to have another. She wants me to have the 4K test because I told her I am tired of being abused only to find that nothing is wrong. I am currently taking Terazosin, is this a problem? She never mentioned that I would have to stop the medication.

    Reply
    • Dr. Geo 02/25/2018, 3:20 PM

      Hi Larry, there is still more information I would need to be able to answer your question conclusively which is the danger of being an internet doctor. But I would say this… If you are in excellent health, she would want to do a biopsy because you may live another 15 years or so. I would do a 4K and that may help determine if another biopsy is necessary. Regarding Terazosin; this is not a problem to improver prostate-related urinary symptoms, per se, and lowers blood pressure – a good thing if you have high blood pressure. Whether or not you should stop the medication depends on if you’re symptoms are improved or not. Good luck.

      Reply
      • Larry Deschaine 03/01/2018, 3:44 PM

        Thanks Dr. Geo. I was reluctant to have the 4K test because Medicare does not pay for it, and my secondary (Tricare for Life) will require me to pay the $195 dolars which they do not cover.

        Reply
        • Dr. Geo 03/05/2018, 11:20 AM

          Understood. It is a tough call and difficult for me to guide you further over the internet, Larry. All the best.

          Reply
  • Mark Evans 08/31/2018, 9:44 AM

    How does Finasteride affect the 4K test. I used to take it but haven’t for almost two years. My Urologist wants me to start again AND take the 4k test asap. He did not mention the possible interaction while taking Finasteride ?

    Reply
    • Dr. Geo 09/11/2018, 5:54 PM

      That is a good question, and it (Finesteride) may falsely lower the 4K since is falsely lower PSA.

      Reply

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