Gentlemen: pay attention! No doubt, for years you have been getting your PSA measured and the doctor reports to you a single, important number- your PSA. Fine. However, that number may give a man a problem. If it is relatively low, he may think he is prostate cancer free; if it is high, he may think he has prostate cancer. Either way, that simple number can be misleading.
Yesterday I received an email from the Cleveland Clinic which told me to check a new lab result in My Chart, the electronic data regarding my visits to the facility. I wondered what it was about because in May I already had my yearly PSA test and noted that the number continued its steady downward trajectory since I began treatment with the Rx Proscar.
A ‘new lab result’ noted Percent-free PSA. Apparently, my doctor assumed I knew the term, but I needed to do some research. Cancer.org states this:
PSA occurs in 2 major forms in the blood. One form is attached to blood proteins while the other circulates free (unattached). The percent-free PSA (fPSA) is the ratio of how much PSA circulates free compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not.
Thus, it’s not the number any longer that is most important but rather a combination of PSA number as well as the percent-free. My brother-in-law, 6 years my senior, has undergone 7 prostatic biopsies because his PSA number is usually over 7. He is cancer-free. Several weeks ago he said to me, “I’m not doing that PSA stuff any more!” At age 77 he probably wouldn’t need it anyway, but had his doctor done a percent-free PSA analysis, the biopsies would not have been necessary.
At your next routine exam, ask your doctor to have the lab do the fPSA analysis from the routine PSA blood test. It might save you angst, time and money.