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Confused by lab results

Posts: 2
Joined: Jun 2018

I decided to get a PSA test as my uncle passed away from PC at the age of 68 this year. I am only 44 but for the last 10 years I have noticed that in the mornings my urine stream is not as robust as it used to be. 

My total PSA came back at 2.3 but my total free PSA percentage is 17% 

My family doctor did not seem concerned. 

I thought that if the free PSA % is low that is a cause for concern? And that I am at the high end of the scale for normal total PSA as well . 

Does anyone have any insight on this? 

THanks! Don

VascodaGama's picture
Posts: 3371
Joined: Nov 2010


Welcome to the board. In my opinion you are right in doing the tests and being concerned with the results. Your uncle's PCa experience places you at higher risk (2x) to contract the disease. If your dad has it then the risk is higher at 4x.

It is not common to have urination issues/symptoms due to prostate cancer (PCa) unless this is in a very advanced status. Urination retention or urge is many times associated to hyperplasia or infection/inflammation. These conditions have nothing to do with cancer and can increase the PSA value. Other factors that can increase the PSA is sex or riding a bike (or tractor, etc) the day before drawing blood for the test. The free PSA at 17% is on the border line but the total PSA used in the calculations can be a faked value if hyperplasia or any other aspect was involved in the result.

In your shoes I would try checking the issue starting with a protocol of antibiotics/anti-inflammatory dugs taken during three weeks and follow with a PSA test one month later. A biopsy is the ultimate means to diagnose cancer. It is invasive so that you can try also testing other biomarkers proper to idetify PCa, such as;

PCa3 (genetic analysis of cells in the urine)
PAP (prostatic acid phosphatase)
CEA (Carcinoembryonic Antigen)
NSE (Neuron Specific Enolase)
CGA (Chromogranin A)
PHI (Prostate Health Index–pro-2PSA)

I hope that cancer is not the issue but you need to be vigilant.

Best wishes.


Posts: 2
Joined: Jun 2018

Hey VGama ,

Thanks so much for the reply.

So are you saying the free PSA % can be thrown off by an elevated total PSA for some benign reason? Thanks again. I will be vigilant! 

Posts: 473
Joined: Mar 2017

good luck Don. Welcome to the world of prostate pathology.

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