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Additional Testing

The most common screening tool for prostate cancer is the prostate-specific antigen (PSA) test. This test is usually the first step in any prostate cancer diagnosis. However, the PSA screening by itself cannot tell you if cancer is present.

Recent research has yielded additional biomarker tests which look for genes, proteins, and other substances (called biomarkers or tumor markers) that can provide information about cancer. These biomarker tests, in addition to the PSA, DRE (Digital Rectal Exam), and Biopsy, can give doctors and patients more information on how to determine the probability of both finding cancer during a biopsy and determining how aggressive that cancer is likely to be. Some of those tests include:

  • 4KScore: A blood test providing patient-specific probability of finding an aggressive form of prostate cancer during a biopsy. Doctors and patients can then make an informed decision on whether to have a biopsy. The test measures total PSA, free PSA, Intact PSA, and for certain enzymes called kallikrein. An algorithm used with the patient’s age and physical exam gives a probability percentage of having aggressive disease.
  • ConfirmMDX: For patients with an initial negative biopsy, the ConfirmMDx test can make a significant prediction of patient outcome compared to other factors alone such as age, PSA and DRE results, race, and family history. It can help avoid repeat biopsies.
  • ERG Protein Marker: A marker used on prostate tissue after a biopsy, which measures ERG protein assays. This helps doctors identify patients who have the disease or have pre-cancerous lesions that indicate a patient is more likely to develop prostate cancer over time.
  • Know Error: A safeguard system of matching DNA samples from a biopsy to cheek swabs to confidently confirm a patient’s identity and diagnosis, ruling out contamination errors in the diagnostic process.
  • SelectMDx: A urine test for individuals with an elevated PSA level. It can provide better insight on personal prostate cancer risk for aggressive disease and whether you should have an initial prostate biopsy.
  • Phi: The Prostate Health Index combines three blood tests that give a more accurate “Phi Score,” which gives information based on a high PSA to better determine the probability of finding cancer during a biopsy.
  • PCA3: A urine test done in men with a high PSA level whose initial biopsy did not show cancer. The test more accurately detects the possibility of prostate cancer by examining the expression of PCA3 – a gene specific to prostate cancer. The PCA3 score is used to determine the need for repeated biopsies. 
  • StoreMyTumor: Specializes in collecting, processing, and storing viable tumors for all types of cancers, which helps patients take advantage of the most personalized treatments and leading-edge diagnostics. Using StoreMyTumor, patients can store tissue collected from a surgery or biopsies; storing tumor tissue increases treatment and diagnostic options. StoreMyTumor will coordinate the collection and storage process, and help physicians and patients connect to cutting-edge technologies that may be beyond the standard of care.

To learn more about biomarkers and biomarker tests, select our Prostate Cancer Biomarkers and Family History resource below.

Ask the Doctor – Prostate Cancer Biomarkers and Family Hist…

Genomic tests are another tool that can help provide information on how aggressive your cancer is likely to be. Test results may help you and your doctor better understand your particular cancer and choose the best treatment option for you. 

While none of these tests are conclusive on their own, when performed in addition to a PSA test, DRE (Digital Rectal Exam), and a biopsy, they can provide each patient with more information about their specific cancer and can aid in both the diagnosis and decision on treatment.


ZERO Prostate Cancer provides this information as a service, and does not endorse any particular product. It is not intended to take the place of medical professionals or the recommendations of your healthcare team. We strongly suggest consulting your healthcare team if you have questions about your specific care.