A PSA on PSA – An Update

In my post of January 10, 2016, I spoke of issues relating to my elevated PSA (“prostate specific antigen“).  Past tests have been negative.  But the PSA numbers continued to remain high.  My urologist at the University of Chicago suggested a brand new test (developed in the last year or two) – called the “4K” test.  Instead of measuring PSA which is helpful but not determinative (and often unreliable), the 4K test measures four “kallikreins” (metrics which can more readily identify prostate cancer).  He also recommended an MRI with a contrast dye this time.  This too is readily new – and provides “highlights” of trouble areas.  

I had the 4K test and the MRI with contrast dye.   The 4K results are  reported in percentages:  “less then 10% chance of having a significant cancer (Gleason score more than 7).”  The MRI was even more optimistic (translation:  less than 5% chance of malignancy).   The two tests together were highly optimistic.  

Some men have a genetic propensity to higher PSA.  Prostate size can affect PSA and the aging process (lot of that going around) can elevate PSA.  And then there’s cancer. . . .     

It’s not fun to hear about medical issues (or non-issues).  But I believe it is important to my brethren  (and the brethren of my sisthren) to know about these two new means for detecting prostate cancer.  

Prior to 1988, prostate cancer was diagnosed by palpitation of lumps or hard nodules.  Then a biopsy.  Or – a man would develop chronic back pain (and then be diagnosed).  In 1990, the PSA test became widely used.  But elevated PSA often resulted in unnecessary biopsies – or surgery.   It is only in the last couple years that new diagnostic tools have been developed:  4K and contrast dye MRI’s.  Thank heaven for modern medicine. . . . .