Free PSA: Understanding Test Results

There is a slew of tests that doctors recommend to determine the likelihood of prostate cancer, one is free prostate-specific antigen (Free PSA).

Free prostate-specific antigen test or Free PSA Test

The growth of cancerous tumors depends on several factors such as lifestyle, environmental factors, diet, and even age. Others are also at higher risk due to genetics.  Of course, while the susceptibility of some may be higher than most, it doesn’t mean that one should just leave everything to fate as there are methods that can at least help reduce the possibility.

Cancer affects all individuals regardless of gender.  There’s one form of cancer though that befalls some men  – prostate cancer. There is a slew of tests that doctors recommend to determine the likelihood of prostate cancer, one is free prostate-specific antigen (Free PSA).

Prostate Cancer and Diagnosing It

The prostate is a gland that occupies space between the penis and the bladder of men.  The purpose of this almond-shaped gland is to nourish the sperm and help it move to its destination, as the egg cells.

The cancerous tumor in the prostate grows due to several factors and when it does, it shows various signs such as difficulty in urinating, presence of blood in the semen, pain in the pelvis and even bones and erectile dysfunction.   The growth may at times be slow and even only be confined within the gland. However, if its too aggressive and not acted upon swiftly, it could not only weaken the prostate but also spread and metastasize to other vital organs.

The occurrence of Prostate cancer becomes higher as the person ages. Certain ethnicities have higher risk too and even, poor diet.

Doctors diagnosing the presence of cancerous tumors in the prostate can at least rely on several tests like a biopsy, PSA test, and Free PSA test.

PSA and What Free PSA Means

The prostate gland secretes a compound called protein-specific antigen. PSAs are important as it plays a role when the sperm reaches the female fallopian tubes and when it fuses with the eggs cells leading to conception. During ejaculation, PSAs are spread into the bloodstream.

When diagnosing prostate cancer, PSA cells are measured including free PSA.  Free PSA should not be assumed that the testing is free. PSAs are actually categorized into two: unbound or attached PSAs that floats in the bloodstream fused with other proteins and, free PSA that floats on its own and not attached to any protein.  Measuring the levels of the two is important in diagnosing the presence of prostate cancer or any ailments that affect the prostate. Other ailments that also measures both free PSA and attached PSA includes prostatitis and swollen prostate.

Doctors could instruct the patient to take the tests measuring the levels of both PSAs and other assessment tests to rule out any possibilities.  They call this total PSA.

Free PSA and How it is Measured

So how does one know if the prostate has cancer through free prostate-specific antigen? In determining prostate cancer, the levels of both bound PSA and free PSA are measured.   The lower the level of free PSA in the bloodstream, the higher the probability of the person having an advanced case of prostate cancer or the risk of developing one.  However, using the free PSA test alone does have certain limitations; at times the test would falsely show what the real state is. For example, in reality, the level is normal but the tests would show lower levels.

Hence for better discernment, the doctor would recommend taking a free PSA test after the usual total PSA test. In a normal PSA test, both free PSA and unbound PSA in the bloodstream are measured and then compared.  If the free PSA tests show that free PSA antigens are higher than unbound PSAs, then the possibility is lower. Thus, doctors often recommend to take free PSA and unbound PSA test for complete assessment and also, if the results of only the unbound PSA is too borderline or too close to call.

Measuring and Understanding Free PSA Test Results

Assessing the test result is better understood when compared to the results of the total PSA test count.  As the higher, the free prostate-specific antigens are, the lower the risk hence comparing the levels with its relation to age is vital.

In measuring the total PSA, doctors count the nanograms per milliliter.   For below 49 years, total PSA should be between 0 to 2.5 ng.ml; 50 to 59 at 0 .0 to 3.5 ng per mL; 60 – 69 years fro  0.0 to 4.5 ng per mL and; 70 onwards fro 0.0 to 6.5 ng/mL.

In gist, the higher the level of free prostate-specific antigen to total PSA the lower the risk. Higher total PSA does not directly say that prostate cancer is present, but the risk is higher. Measuring the acceptable level according to age is important.

In most cases, urologists measure Free PSA with patients with a total PSA level between 4 ng/ and 10 ng/mL. Those that have this total PSA level but with a test result of Free PSA that is higher than 25% have a lower chance of having prostate cancer.

Ethnicity also is crucial since some have a higher possibility of developing prostate cancer.

However, one should also take note that some factors do affect the level of PSA which does not necessarily suggest that the man is high risk or have prostate cancer. Some of these factors that can affect include: anal sex, surgery in the prostate, injury of the prostate during intense physical activity such as horseback riding and cycling, ejaculation, swelling of the prostate and medicines for treating enlarged prostate glands.

Is Testing the Level of Free PSA the Most Effective?

The combination of total PSA and Free PSA is what doctors most often prescribe to determine and compare the level.   Free PSA test however at times is enough and eliminates the need for the patient to take a biopsy, which is more invasive and can cause fear to the patient.  However, if the doctor requests an additional biopsy after the test, then it should not be ignored since biopsies can further provide accuracy.

Reducing the Risk of Developing Prostate Cancer

While taking this test is indeed helpful, eliminating the need can be reduced if certain lifestyle and dietary changes are incorporated.  These could be working out regularly, eating healthy foods such as vegetables and fruits, lessening the reliance on supplements and controlling weight gain.

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