Causes for low % free PSA ?

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AKRoamer
New Member


Date Joined Nov 2008
Total Posts : 15
   Posted 11/17/2008 2:29 AM (GMT -6)   
Hello, I'm new to posting on the forum but I have been reading posts for last 3 months.  The other "well-known" forums turned me off, just had a bad tone about them.  I appreciate people passing on info about their experiences on this forum.

I had an elevated PSA / low %fPSA picked up on a routine blood lab.  My exam and biopsy was negative, the uro did note that my prostate was enlarged (I live in a small town in Southeast Alaska, no urologist in town, I had to go to Seattle [Virginia Mason hosp] for a biopsy). Does anybody have any info on what could cause low % free PSA other than prostate cancer?
 
I've read the book by Dr. Walsh; he states that BPH produces mainly free PSA and prostate cancer produces mainly bound PSA, therefore elevated PSA/low % free PSA "more than likely" indicates prostate cancer.  I assume by "more than likely" he means greater than 50% chance.  My PSA test results from the lab had a note that chance of prostate cancer was 56%. 

Dr. Walsh's book said nothing about what else may cause a low % fPSA, and I have not found anything else about it looking online.  My family doc was/is very concerned about my low fPSA, the uro I saw for the biopsy told me to repeat the DRE/PSA test 6 months after the biopsy and we would decide then if another biopsy is needed.  My doc does not want to wait that long, will repeat the PSA test in Dec. 

While I am very happy that biopsy was neg, this low % free PSA is really bugging me.  Hoping someone has some info as to what else causes low % free PSA.
 
Thanks,
 
Dan
 
 

 

Age 48
PSA 6/2003 1.5
PSA 7/2008 4.8, % free PSA 8
3 weeks Levaquin
PSA 9/2008 5.2, % free PSA 7
Biopsy 10/08 neg


aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 11/17/2008 6:00 AM (GMT -6)   
 
What is the size of your prostate ?
 
Was your biopsy "Transperineal"  ?
 

AKRoamer
New Member


Date Joined Nov 2008
Total Posts : 15
   Posted 11/17/2008 1:34 PM (GMT -6)   

Uro did not say how enlarged my prostate was, I failed to ask specifically.

Have not had any symptoms of BPH.

Biopsy was transrectal w/ ultrasound.


Age 48
PSA 6/2003 1.5
PSA 7/2008 4.8, % free PSA 8
3 weeks Levaquin
PSA 9/2008 5.2, % free PSA 7
Biopsy 10/08 neg


aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 11/17/2008 7:07 PM (GMT -6)   
The prostate naturally produces PSA, and the larger it is is the more PSA is produced.  Prostate size needs to be factored into the equasion for PSA numbers to be meaningful.  Information on size would now be available to you.
 
Where there's reason to suspect PC which has not been detected by previous "normal" biopsy, a doctor who is skilled with the "Transperineal" biopsy technique will often use this method, which can often detect a cancer that had not been located previously.
 
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