Oncology (High-Grade Prostate Cancer), biochemical assay of four proteins (Total PSA, Free PSA, Intact PSA and human kallikrein 2 [hK2]) plus patient age, digital rectal examination status, and no history of positive prostate biopsy, utilizing plasma, pro
CPT4 code
Name of the Procedure:
Biochemical Assay for High-Grade Prostate Cancer (Total PSA, Free PSA, Intact PSA, Human Kallikrein 2 [hK2]), using Plasma, with Patient Age, Digital Rectal Examination Status, and No History of Positive Prostate Biopsy
Summary
This procedure is a blood test used to evaluate the risk of high-grade prostate cancer. It involves measuring four specific proteins in the blood along with considering the patient's age and the results from a digital rectal examination (DRE). The proteins tested are Total PSA, Free PSA, Intact PSA, and Human Kallikrein 2 (hK2).
Purpose
The purpose of this procedure is to assess the likelihood of high-grade prostate cancer, a more aggressive form of prostate cancer. The goal is to provide a more accurate diagnosis, which can lead to more appropriate and timely treatment decisions.
Indications
- Elevated PSA levels
- Suspicious findings from a digital rectal examination
- Individuals at higher risk for prostate cancer (e.g., family history, older age)
- No previous history of positive prostate biopsy
Preparation
- Fasting is typically not required.
- It is important to inform the healthcare provider of any medications or supplements being taken.
- Patients may need to avoid ejaculation or vigorous exercise a few days before the test, as this can affect PSA levels.
Procedure Description
- Blood sample collection: A healthcare professional will draw a blood sample from the patient's vein.
- Protein assays: The blood sample is analyzed in a laboratory to measure levels of Total PSA, Free PSA, Intact PSA, and Human Kallikrein 2 (hK2).
- Data integration: The protein levels are combined with patient age and DRE status to calculate the risk of high-grade prostate cancer.
Duration
The blood draw itself takes a few minutes. Laboratory analysis and integration of results may take several days.
Setting
The blood sample collection is typically performed in a hospital, outpatient clinic, or diagnostic laboratory.
Personnel
- Phlebotomist or nurse to draw the blood sample
- Laboratory technicians to analyze the blood sample
- Physician (e.g., urologist or oncologist) to interpret the results
Risks and Complications
- Minor discomfort or bruising at the blood draw site
- Rare risk of infection or excessive bleeding
Benefits
- Provides a more comprehensive risk assessment for high-grade prostate cancer
- May help avoid unnecessary biopsies
- Facilitates early and accurate diagnosis, leading to better treatment outcomes
Recovery
- There is no recovery period required as this is a minimally invasive procedure.
- Patients can typically return to normal activities immediately.
- Follow-up appointments may be scheduled to discuss results.
Alternatives
- Traditional PSA testing alone
- Advanced imaging techniques (e.g., MRI)
- Direct prostate biopsy (more invasive and has its own set of risks)
Patient Experience
- The blood draw is usually quick and involves minor discomfort.
- Patients may experience some anxiety while waiting for the results.
- The healthcare team will provide pain management options if necessary, although discomfort is typically minimal.