The PSA test cannot differentiate between prostate cancer and non-cancerous (benign) conditions, such as benign prostatic hyperplasia (BPH). Men who receive a PSA level above 1.5 ng/ML should discuss additional biomarker testing with their healthcare providers prior to considering a prostate biopsy.

Prostate cancer biomarkers (PCMs) are molecules found in blood, tissue, or body fluids. PCMs are revolutionary new, non-invasive diagnostic tests that may help your healthcare provider decide if your prostate cancer is in fact low risk, if something more aggressive may be lurking in your prostate, or if there are hot spots in the prostate that may need to be re-evaluated upon biopsy. PCMs also can help you and your healthcare provider determine the most appropriate treatment for your cancer.

There are many factors that will make one prostate cancer marker test better suited for individual cases. Many times, individuals who have never had a biopsy or had low to intermediate grade prostate cancer (Gleason 3+3=6 or 3+4=7) diagnosed on a biopsy are well suited for blood or urine prostate cancer markers, whereas individuals who have persistently negative biopsies or a biopsy of intermediate to high grade cancer may benefit from tissue prostate cancer markers. Use this interactive questionnaire to see what tests may be right for you.  Once you’ve completed the questionnaire, discuss the results with your healthcare provider. Also be sure to check out our Patient Journey section that may help you decide which test is right for you.

Although there are many factors that contribute to your healthcare provider’s decision to conduct a prostate biopsy, there are several urinary and blood based PCMs that may help guide you and your physician through the decision of conducting a prostate biopsy. These include:

• Select mdx
• 4K
• Prostate health index (phi)
• ExoDx

Genetic tests also may be worth considering if you have a family history of prostate cancer, breast cancer, ovarian cancer or colorectal cancer. These genetic tests are recommended for men who are determined through genetic counseling to be at potential risk for hereditary cancer:

• Myriad myRisk
• ProstateNext
• Ambry Score

Good candidates for the FDA-approved blood test, Prostate Health Index (phi), are men with abnormal digital rectal exam (DRE), a PSA between 2-10 ng/ml, a low risk (Gleason 3+3=6) prostate biopsy, or men with a previously negative prostate biopsy.

The phi test measures three things: Total PSA, Free PSA and Pro2PSA. Results are placed into an equation that produces the phi score.

While you should always consult with your physician when reviewing any test results, in general, the Beckman Coulter phi range for probability of prostate cancer risk upon biopsy are:

• phi between 0-26.9: 9.8% risk
• phi between 27-35.9: 16.8% risk
• phi between 36-54.9: 33.3% risk
• phi greater than 55: 50.1% risk

See sample phi test results and learn more about how to interpret the test report.