It would be highly unusual to have PC at your young age, although anything is possible. Your total PSA is somewhat elevated and your free PSA of 17.6% is fair. Anything under 10-15 is considered suspicious and anything over 25% is considered very good.
A PSA reading, by itself, is usually not an indicator of PC. Some men have PC with an almost zero PSA reading, while others with large PSA readings have no PC.
Do you have any family members (blood related) who have had PC? If so, your chances of getting it are much higher than normal -- although it would still be unusual to develop it in your 20s. An infection, etc., is more likely than PC.
But still, with your tPSA and fPSA readings, it would be wise to begin regular PSA testing to develop a baseline and a history of readings, perhaps once a year. The thing the urologist will be looking for is a SPIKE in the PSA. If the number should rise -- but only gradually -- it may not be any problem.
But if the number should suddenly begin to rise and perhaps double over a year or two, it is a possible indicator of PC.
It is possible that a prostate biopsy might be in the future if the above should happen.
My advice would be to just keep checking your PSA once a year (or even every 6 months if it continues to be elevated) to keep an eye on it. Then, if any PC should be found in the future, it would likely be still at a highly curable stage.
Once again, though, remember that it is rare to have PC at your age, so do not lose any sleep over this. Just stay on top of things and you should be okay.
Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1. PSA tests now annual.
Semi-firm erections now happening 14 months post-op & VERY slowly getting a bit stronger.
Post Edited (HighlanderCFH) : 5/29/2013 2:45:02 AM (GMT-6)