Percent-free PSA

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. 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.



7 thoughts on “Percent-free PSA

  1. My friend, if you could only move here to France. The medical system here gives you every opportunity for free screening. It’s all about prevention…

    1. Yes, of course Europeans would have the maturity and wisdom to provide such services to its citizens at low or no cost. I’ve often made the comparison between the U.S. and Europe as between an adolescent and a fully-functioning adult.

      Remember those awful adolescent years when most everything was a ‘challenge?’ We had to prove ourselves by questioning, challenging, defying. We ‘knew better’ than our parents and elders. We longed for ‘freedom’ which, often, turned out to be the ‘dom’ part more than the ‘free.’

      I note many adult-male-adolescents in the U.S.A. By that I mean they never left the adolescent years behind and never became fully-functioning adult males. One clue to this is the American love for guns. Think about just that fact alone. The question arises: why do American males believe that they need guns in their house for ‘protection’ whereas European males who own them exclusively for sport? What does that indicate?

      To me it says that fear is rampant here in the U.S. And many on the right-side of the political spectrum fear not only ‘them’ but equally the government. Wow! That’s quite the heavy mental burden to carry around day after day.

      This brings me to health care and the seemingly endless battle being waged against government-sponsored health care provisions and guides. Not surprisingly, however, the +65 group enjoys its Medicare provisions and perks. What do the 30, 40 and 50-year-olds have against our health care system? Or is it just the mindset- the throwback to adolescence when ‘they’ didn’t want people [parents] telling them what was good for them? Are they still stuck in that mentality?

      As a result, therefore, insurance companies prod these useful idiots to rant and rave about government intrusions into their lives- authorities who have ‘no business’ telling them what they can and cannot do. Naturally, the right-wing media reinforces this imagined intrusion and with a little payola, rants and raves 24/7.

      America- the land of the free and home of the [ insert ].

  2. M_R, I haven’t had my PSA taken for at least 3 years if not more. Didn’t you read the study report that the numbers are meaningless? It was just more of the bogus hype of physicians to increase their bottom line. For a large part
    of the AMA it is a business first. How many scripts they can give us, how many tests, or procedures. If religion is a myth, so to is it a myth that doctors
    are concerned about our wellness. Yes, a professional and ethical surgeon
    is essential.

    Please go to USA Today and read “Doctors perform thousands of
    unnecessary surgeries” from a couple days ago.

    It’s in the tens of thousands each year. The most involve cardiac, spinal,
    knee and hip replacements, hysterectomies, and cesarean procedures.
    Because of their legal monopoly most doctors are able to escape legal
    proceedings by making a payment and avoid any malpractice issues. Many
    of the surgeries leave thousands of people(victims) dead(we read all the time
    that the deceased dead from surgical complications. A sweet term for murder!). If not dead, they have serious impairments.

    As early as 1974 a congressional committee reported that there were over two million cases a year of unnecessary surgeries which caused the death of
    12,000 people. Did our congressperson send us that report? Oh, silly me!

    Medicine for the most part is a fraud played on the lives of an ignorant public
    and their pocketbooks, and on the national treasury too. Please go to the article and read it

    1. I don’t need to read the article; I know it is true. My brother-in-law, as reported, has undergone 7 prostatic biopsies due to his ‘high’ PSA number. You and I helped pay for them as he is on Medicare.

      He and I (used to) go to the same urologic group. As you may recall, when my number hit 7, my doc reached for his scalpel and I headed for the Cleveland Clinic.

  3. Yep I know, and he puts you on proscar, every month the Kaching of his take from the re-order is his reward from Big Pharma. Proscar has serious
    side effects. The active ingredient is finasteride which is known to cause an increased risk of “high grade” prostate cancer.

    Now that’s scary isn’t it? He prescribes a drug, because Big Pharma tells him to and if you do what we tell you we will give you a commission or kickback on your sales and/or you sell so much we will throw in a ski trip
    to Aspen. And then Drs. have the stupidity to post a group picture on their walls and proceed to tell you how they earned that free all expense trip.

    Here are some of the other side-effects of Proscar: male breast cancer,
    decreased breathing problems, increasing depression, decreased erection,
    diminished orgasms, lessens libido, testicular pain, increased headaches,
    and decreased stamina.

    Hell, with all those effects it might be better to to let the doc with the scaple have at it, lol!

    You need to look at that usa today article as I only scatched the surface, and i’m sure you can find it much faster and easier than I, lol

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