Question: And what about Total 8.4 and Free 2.3 on established prostate cancer. PSA total was 4 less than a month ago, free wasn’t tested then.
Answer: The Free PSA according to your numbers is about 27% which carries a little risk of cancer, but must confirmed with other DRE with symptoms and MRI.
As you wrote, PSA 4.0 is a borderline which means you must retest within few months to make sure it will not increase.
About 15% of men with normal PSA (less than 4.0) can have prostate cancer.
Free PSA% can only filter some cases to minimize the waiting list for surgical biopsies.
And therefore, PSA test is only one tool to judge on the prostate enlargement and not the only one.
The secret key for correctly using PSA in diagnosis of prostate cancer is the follow-up to know if the PSA level increasing or not.
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