Hi Teb (Tom)
Glad to be of help where I can! Glad to hear you are going to the Cleveland Clinic for your 2nd biopsy and PSA tests (including free PSA). The Cleveland Clinic has a fine reputation. I can find nothing which expresses free PSA in other than a percentage. You doctor tells you that your free PSA is 0.2 and says it is normal. It tells you and me nothing. See tables below which predict the chances of PC based on PSA and free PSA levels. PSA is certainly expressed as 0.2 which usually relates to those patients whose prostate has been removed or who have had radiation treatment (essentially the PSA is supposed to drop close to -0- after treatment if there is no remaining cancer). with radiation, 0.2 is considered the low nadir indicating that there is no cancer (at least at the time of the test).
Free PSA and PSA chance of disease
Probability of Cancer based on PSA and % FPSA (Free PSA) results (men with non-suspicious DRE results, any age): % FPSA can stratify risk for men with PSA between 4 and 10 ng/ml.
PSA_ Probability of Cancer
%FreePSA Probability of Cancer
>25%__________8% The original of this was presented in the JAMA 279:1543, 1998
Again, my PSA was under 10 and my free PSA was 27%--I was one of the unlucky ones considering that my chances of getting PC were statistically smaller than others.
Deferring your treatment until you get definitive confirmation that you have PC makes sense. Just remember that any kind of treatment, including proton which is considered a safer form of radiation treatment, will have ultimate side effects that can affect the quality of your life. For most patients in an earlier stage of PC, the cancer is slow growing and you usually have a window of opportunity of a few months before the need to start treatment ( at least that is the opinion of some of the experts from what i have read).
Good luck on your biopsy and PSA tests. Looking forward to hearing good news after your tests on April 2,
P.S. I am in the process of being treated at MGH (Massachusetts General Hospital) Proton Center in Boston. It is the closest proton center to where I live. I didn't want to travel 3000 miles to Loma Linda. I have no reason to believe that my treatment is not comparable to Loma Linda. The radiation oncologist who is directing my treatment is considered among the best in his field. It has only been recently that other proton centers have been
opening for treatment of many kinds of cancers, including prostate. So Loma Linda is no longer the only option for proton treatment of PC.
68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07.
Post Edited (pcdave) : 4/1/2007 9:51:42 PM (GMT-6)