Q:PSA Level Interpretation for 73 year man Total PSA 8 Free PSA 13.5 without symptoms
The original question:
73 year old man here. Had a PSA test as part of recent Medicare Wellness Visit. My first PSA reading was 8.3 with a free PSA of 13.5. My second readings, taken 2 1/2 weeks later were 7.0 and a 13.5 free. Other info worth noting: was diagnosed with BPH 15 years ago and had laser surgery that successfully relieved urinary flow problems. Have not had any problems since. Also, I’ve shown no other symptoms known to be associated with prostate CA such as blood in urine or semen, etc.. I’d be interested in your opinion. Thank you.
Answers:
1. Free PSA values range is from 0.2 to 5.0 ng/mL
2. Higher risks of prostate cancer associated with high total PSA and low Free PSA%
For asymptomatic men:
1. If total PSA is below 2.0 regardless of Free PSA%, the probability of prostate cancer is very low.
2. If TPSA is greater than 10, the probability of prostate cancer is high and must confirm by doing biopsy from the prostate.
3. If total PSA is in the grey zone from 4 to 10 then we need (the ratio of free PSA:total PSA) in order to determine the relative risk of prostate cancer.
In your case, FPSA:TPSA ratio is 1.6 and 1.9 for the two tests you done, and according to “mayocliniclabs” that any ratio >0.25 in men older than 70 years the percent probability of finding prostate cancer on a needle biopsy is below 16% which is very low when compared with the ratios lower than 0.1 that has the probability 65%.
Also, I recommend to search for other explanations written in this website if you need further information.