It is very important that you follow up with your urologist about your free PSA level.

Free PSA is the portion of PSA that circulates unbound in the blood and is usually expressed as a percentage of total PSA (free PSA ÷ total PSA × 100).

A lower percentage increases the likelihood of prostate cancer, while a higher percentage suggests a benign condition.

If your total PSA is 10.3 ng/mL and your free PSA is actually 0.68 ng/mL, as you indicate, then your Free PSA % = (0.68 ÷ 10.3) × 100 ≈ 6.6%.

A free PSA percentage of 6.6% is quite low and suggests a higher likelihood of prostate cancer.

I’m low volume 3+4, with low risk Decipher score and a PSA averaging 6.6….also on AS. I will only reluctantly consider a follow up biopsy, if/when a follow-up mpMRI shows lesion progression…so I understand your concerns about biopsy.

That said, IMHO if I had PSA numbers and a MRI as you report; I would not hesitate to get a targeted MRI biopsy and a Decipher score….it may come back “low risk” and you can continue AS….but at least you know what you’re dealing with.

All the best,

Alan