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Old 11-12-2012, 10:30 AM   #1
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Reminder about PSA terminology please

You may know I am now living in a country with little experience of Brachytherapy for PC. I have been asked to explain to my GP here what the state of play is. Up to now my local lab results have come back with one figure for "PSA" with a preprinted "attention" level of 4.0 ng/ml.

However my latest result has come back showing:
free PSA <0.010 ng/ml
total PSA 0.049 ng/ml "attention" level 4.0 ng/ml

I am happy that these are excellent results, but can someone remind me what the significance of "free PSA" is (in case the GP asks).

Thanks
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Peter, Brachytherapy in Guildford, England March 2008

 
Old 11-12-2012, 11:26 AM   #2
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Re: Reminder about PSA terminology please

At the site of the National Cancer Institute you can read details about the PSA and its “derivates” when in the diagnosis and control of treatment progress. Here is the link;
http://www.cancer.gov/cancertopics/factsheet/detection/PSA

From the Wikipedia they write this;
“Free PSA
Most PSA in the blood is bound to serum proteins. A small amount is not protein bound and is called 'free PSA'. In men with prostate cancer the ratio of free (unbound) PSA to total PSA is decreased. The risk of cancer increases if the free to total ratio is less than 25%. (See graph at right.) The lower the ratio is, the greater the probability of prostate cancer. Measuring the ratio of free to total PSA appears to be particularly promising for eliminating unnecessary biopsies in men with PSA levels between 4 and 10 ng/mL.[37] However, both total and free PSA increase immediately after ejaculation, returning slowly to baseline levels within 24 hours.”

The results of your last test calculate a ratio of free PSA at approximately 20% but your PSA of 0.049 is so low that hardly you would find a doctor diagnosing you with prostate cancer.
I wonder what made you take a free PSA. Have you had a positive DRE?

Regards.

Last edited by Baptista; 11-12-2012 at 11:48 AM.

 
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Old 11-12-2012, 12:16 PM   #3
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Re: Reminder about PSA terminology please

Thanks Baptista.

I didn't ask for free PSA, that is just how the result came back this time. I got an updated PSA test because I have a painful back and one of the things they want to rule out is any spread from my anhialated prostate. I was hoping the low PSA would get them back on track to finding a more likely cause of my back pain.
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Peter, Brachytherapy in Guildford, England March 2008

 
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