Free PSA in Dehradun

What is a Free PSA?

Prostate-specific antigen circulates in two forms: bound to proteins, and free. Total PSA measures both together, and it has a well-known weakness in the range between about 4 and 10 ng/mL, sometimes called the diagnostic grey zone, where a benign enlarged prostate and an early cancer produce overlapping values. Free PSA exists to sharpen that decision. The useful observation is that prostate cancer tends to produce PSA that is more heavily protein-bound, so a smaller proportion circulates free, while benign enlargement produces relatively more free PSA. The result is therefore reported as a ratio rather than a raw number: a higher free-to-total percentage points towards benign enlargement, a lower one raises concern and makes a urologist more inclined to recommend a biopsy. The ratio is a probability tool, not a verdict. It shifts the odds and helps some men avoid an unnecessary biopsy while prompting others towards a needed one, but only a biopsy diagnoses prostate cancer, and only a urologist should interpret the ratio against your age, prostate size, examination findings and how the value has changed over time.

Why take this test?

A free PSA test is advised for men whose total PSA sits in the borderline range, typically 4 to 10 ng/mL, where the decision about biopsy is genuinely uncertain. It is ordered with total PSA from the same sample, never instead of it, since the ratio is meaningless without both. It is most relevant for men over 50, and from around 45 where a father or brother has had prostate cancer, since family history raises risk substantially. It is also used when a raised PSA has been found incidentally and a doctor wants more information before referring. Several things raise PSA without any cancer at all, and they matter for timing: a urinary infection, prostatitis, recent catheterisation, cycling, and ejaculation within the preceding two days can all lift the value, so testing should be deferred where any of these applies. Symptoms such as difficulty passing urine, a weak stream, getting up at night, or blood in the urine warrant seeing a doctor rather than simply ordering a test.

• A total PSA in the borderline 4 to 10 ng/mL range
• Deciding whether a prostate biopsy is warranted
• Men over 50 as part of a discussed screening decision
• Men over 45 with a father or brother affected by prostate cancer
• An incidentally raised PSA needing further characterisation
• Always ordered together with total PSA, never alone

FAQs: Free PSA in Dehradun