PSA Result Help: What's the difference between PSA and Free PSA?

Posted by zj69 @zj69, Nov 22, 2022

I went for another PSA test and got the following please can you explain the difference between PSA and Free PSA?

I went for RP, and the pathology report found one pelvic Lymph node position and EPE. No surgical margin.

Prostate Specific Antigen 0.086 <4.0 ug/L
Prostate Specific Antigen Free 0.02 ug/L
Prostate Specific Antigen Free/Total 0.23 ug/L

My first PSA 6 weeks after the removal of my prostate was 0.017.

Thanks

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drj | @drj | Aug 22, 2023

In reply to @lorkem258 "Thanks for the reply.. interesting to see the progression . You tested yearly? Do you have..." + (show)

No family history at all.

I've been measuring PSA for 35 yrs, even through the PSA "drought". I saw the trend and was concerned. My doc was not. I assumed then that since two docs had remarked about my "large" prostate, that the rising PSA was normal for a growing prostate.
At my request, I started % free PSA. I think that was a mistake. Results were equivocal. It lulled me into thinking things were maybe OK. It was not.
Note that I kinda took on the role of an MD. No one else was offering any interpretation. They were apparently trusting the age-adjusted PSA "cutoffs". Mistake. PSA should only be used for trending.