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What (if any) significance is Free PSA % in someone diagnosed with PCa?

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Posted 11/14/2016 11:13 PM (GMT 0)
Hello All,

I had a PSA test today where the doctor ordered the free psa count. I see the results already and my free psa percentage is 23%. This was my first PSA test that reported free psa as well as total. I understand that free psa may be helpful information for people that haven't been diagnosed with PCa, but I'm not sure why it was ordered for me this time and what significance it has to my case since I've already been biopsy confirmed to have prostate cancer.

Thanks for ideas on this :-)

Post Edited (schoolpsych) : 11/14/2016 4:21:03 PM (GMT-7)

Posted 11/14/2016 11:55 PM (GMT 0)
My understanding is the same as yours--that it's mainly for giving you an indication of how likely an elevated PSA is due to PC or something else. I'm wondering if it's just not part of the standard PSA test that your doctor orders.

BTW, I don't know how accurate free PSA is an indicator, but 23% would normally be considered a good score. As I recall, your PSA was pretty high so I'm not sure if that affects the free PSA score. Right before my positive biopsy, my free PSA was 2%.
Posted 11/15/2016 1:00 AM (GMT 0)
Hi Michael,

Yes, my psa at diagnosis was 47. Now at nearly three months since my lupron shot it is down to 1 with the 23 percent free. I have been on lupron only but am now adding Casadex as well.
Posted 11/15/2016 1:57 AM (GMT 0)
Hi Psych,

I'm confused which sadly, is really often. Why are you adding Casadex at this point? I was told it is added when Lupron is no longer working by itself, PSA down from 47 to 1 in 3 months seems awesome to me, but then again I really know little but how mine is going. Mine is down 50% in 2 months yours is down about 96%? I suck at math :) but if that's right why add Casadex yet?

thanks, hoping to learn from everyone else here.

Tekton
Posted 11/15/2016 2:06 AM (GMT 0)
I think you got the test because the doctor liked checking boxes. It is meaningless while on ADT because PSA is suppressed by it.
Posted 11/15/2016 4:56 AM (GMT 0)
The fpsa is for pre-diagnosis to determine if men with slightly elevated psa scores should have biopsies.

As TA said, it is meaningless in your case.
Posted 11/15/2016 6:25 AM (GMT 0)
My PSA was 3.42 so uro did a fPSA% ratio and it came at 7.6% meaning the chances of me having aggressive cancer was increased. Any fPSA% under 10% heightens your chances of high risk cancer.

This was done before my biopsy and was confirmed afterwords as I'm G9.

Wouldn't be a factor after ADT

Mark
Posted 11/15/2016 12:33 PM (GMT 0)
Thank you everyone. I thought it was likely meaningless in my case but wanted to check just in case. Tekton - a subsequent doctor I saw recommended taking the Casadex together with the lupron even though the lupron does appear to be working. As with everything in this PCa world, it seems different doctors have different thoughts on ADT .
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