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Help with PSA reading

Prostate Cancer | Last Active: Aug 19, 2023 | Replies (30)
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@pablo81

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..

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Replies to "Hi. The PSA flag went up for me in Jan 2022 when I was pursuing REZUM..."
drj | @drj | Aug 13, 2023

A little more information:

Unfortunately, this Mayo web site garbled the numbers that were the table tabulating my numbers. It looked fine until I hit the SEND key.

There are/were four columns:
Date, PSA total, PSA change year to year, and % Free PSA(starting 6/17) . Maybe copy/paste could reassemble.

PSA total slowly rose for 17 yrs. BPH?
PSA velocity was steady (consistent with BPH?) until 10/18
PSA "free" wobbled around 20% (probability of cancer 20%?)

Now, you might have a problem with metrics and reference values. To begin with, the "normal ranges" or reference values that I put in the table are not well established, so, for example, the long running so called "normal range" of 4 ng/mL was poorly established but widely used, so it's easy to over-interpret the meaning of these numbers. I suspect this is so for the % Free PSA.

Now, once one starts medical procedures on the prostate such as REZUM, one will have no idea what PSA value if any to use as a reference. I gather you have not started this BPH treatment.

Have you had a diagnostic MRI of your prostate?

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