Low Free PSA

stone91

Good morning,

I was hoping someone can help me understand some of the numbers I had on my PSA test. I am scheduled for an MRI next month, but the results have me a little worried. I am 51 years old and my total PSA came back at 2.4, but my free psa came back at 8. My DRE came back normal and I have no symptoms. Is this something that I should be worried about? Wouldn't my PSA total be higher? Thank you in advance.

Clevelandguy

Hi,

From what I have read men that have a lower amount of free psa compared to the overall psa might have a higher chance of having Prostate cancer. Yours seems the opposite so it might mean good news for you. Total psa is psa bonded to proteins where free psa is not bound to proteins. Usually when your total psa raises above 4 doctors get concerned. Comparing total psa to free psa can give the doctor an “indication “ if you have cancer. The only way to tell if you have Prostate cancer is to do a biopsy. It sounds like your next step is an MRI, biopsy could follow after that if your doctor see something suspicious on the MRI. Good luck with your results.

Dave 3+4

Old Salt

Free PSA is expressed as a percentage. The units for PSA are usually ng/mL.

Because you will be getting an MRI (good idea), I would not lose sleep out of the free PSA result.

acssjm

My understanding is that Total PSA = Free PSA + Protein-bound PSA. If you total PSA is 2.4 ng/ml, free PSA cannot be 8 ng/ml. If free PSA is 8%, it does sound a low percentage. Is this the reason you're scheduled for MRI? MRI is noninvasive. Having an MRI as a gatekeeper for biopsy sounds reasonable to me. Best luck!