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Help with PSA reading

Prostate Cancer | Last Active: Aug 19, 2023 | Replies (30)

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@drj

OK. I'm am also currently 81 yr. Perhaps this is a teaching moment.

Let's look at my data from the recent 17 yrs and see if might help you assess your prostate health. [The prior 16 years, my PSA was < 1.0].

Date PSA, ng/mL Increase, ng/yr** % Free PSA***
5/07 1.2 -
3/09 1.6 0.2*
11/11 1.8 0.1
2/14 2.6 0.3
1/15 2.3 - 0.3
6/16 2.9 0.15*
6/17 2.8 - 0.1 25
10/18 3.9 0.5 * 18
9/19 4.1 0.2 20
11/20 4.9 0.8 20
11/21 6.9 2.0 16
* Averaged over previous two years

** < 0.5 ng/mL/yr is a potential guideline

PSA Total Reference Range:
40 - 49 year old: 0.0-2.5 ng/mL
50 - 59 year old: 0.0-3.5 ng/mL
60 - 69 year old: 0.0-4.5 ng/mL
70 - 79 year old: 0.0-6.5 ng/mL

*** PSA,% Free
Probability of Prostate Cancer for Men with Non-Suspicious
DRE Results and PSA between 4 and 10 ng/mL

Percent Probability
Free PSA of Cancer
0-10% 56%
10-15% 28%
15-20% 20%
20-25% 16%
>25% 8%

So here are total PSA tracking data, velocity, total PSA as a function of age, and % free data. This is the data I and my primary care physician had to interpret. Do you see parallels with your data?

How would you interpret this data? Which, if any, of this data would raise your eyebrow or prompt you to see a urologist? If so, when?

Others should feel welcome to chime in.

I have further data since 11/21 which I will share after you and others have had an opportunity to make an assessment of the data above.

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Replies to "OK. I'm am also currently 81 yr. Perhaps this is a teaching moment. Let's look at..."

Hi. The PSA flag went up for me in Jan 2022 when I was pursuing REZUM therapy on visit to Urologist for my BPH.
It measured 4.54 and opened pandora's box. That is when I had first PSA Free test. Since then
1/10/22 psa total 4.54 with free 1.28 = 28%
4/19/22 5.17 1.67 = 32%
8/23/22 5.22 1.65 = 32%
1/9/23 5.5 1.55 = 28%
Another due this month.
My understanding is the higher percent of free , the better. I now see 2 urologists, one for possible REZUM and other who specializes in PC.
Not sure I can interpret your PSA total and free numbers? What are the percentages of free??PSA total looks ok to me for age. I have low confidence that anyone really knows how to interpret these numbers with certainty.
I have backburnered my REZUM plans for now. My PC urologist says not too concerned about serious PC for now..