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PSA TEST 2.96 Free PSA 0.32

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Posted 4/20/2018 1:45 PM (GMT 0)
I am a little confused, everything I am 60 years old, i read about Fee psa is based on a score of 4-10, I started with kaiser as that is where my insurance is, they said my PSA was 5.6, they re did a test a week later with the same results, and they wanted to do a biopsy, Wait... i wanted to research first, I then asked for a MRI which cam back neg, DRE neg, and doc still wanted to do a biopsy... not so fast... i then did a 4k score, this score is 14%, and came back PSa 2.96... Free psa 0.32 or 11%, so what does that mean when the PSA total is not between 4-10... and what is up with the way different numbers of total PSA from kaiser vs the 4k lab..
Thanks
Posted 4/20/2018 5:00 PM (GMT 0)
Welcome to HW.

Different labs may be using different test methods. One lab could just be plain wrong or your PSA may have fallen. you just can't tell. You might want to ask for PHI test (prostate health index) which could include more useful info. An MRI at your PSA level isn't likely to show anything useful.

Still, there are worse things than a biopsy.

So you can get more blood work - I'd wait a couple of months before doing more - or you can get the biopsy. Tough call,
Andrew
Posted 4/20/2018 7:12 PM (GMT 0)
Hi fatee2k,
Sometimes there can be differences in the PSA results from different labs but 5.6 vs 2.96 is quite a large
difference from what I have seen to conclude it is that different just to different lab/test method unless one is an error. It is possible you have some inflammation in your prostate which can cause the PSA to be quite variable and elevated > 4 and another item that could cause a PSA value to be higher is if you had sex (ejaculation) within about 72 hours of your PSA test or even some exercise such as bike riding that directly impacts the prostate.
I would want to do some further testing and delay a biopsy especially since your DRE and MRI are negative. You may want to consider seeing a different Urologist if all they want to do id a biopsy.
Posted 4/20/2018 8:37 PM (GMT 0)
I commend you for wanting to avoid an unnecessary biopsy - there certainly is a rush to biopsy in the US. However, you have done your due diligence and you can't rule out a high probability that you have prostate cancer.

4Kscore is a better test than PSA alone or free PSA - it includes both and adds two other biomarkers. It has been validated for all PSA values (not just 4-10). In fact, more than a third of the men in the validation study (below) had a PSA under 4. Among men with 4Kscores in the 10-15% range, 40% had prostate cancer discovered on biopsy. OPKO recommends that any 4Kscore over 7.5% be a trigger for a biopsy.

/www.prostatehealthuk.com/media/1411-4Kscore-US-Clinical-Trial-Eur-Urol-2014.pdf

The drop in total PSA may indicate that there is some prostatitis, but because you have high risk of prostate cancer, I'd think you'd want a biopsy.
Posted 4/20/2018 10:16 PM (GMT 0)
Wow... always in denial thinking, no not me, Thanks for the replies, I have a appt with my doc next week, but i'm sure he probably will still want to do a biopsy. Thanks again
Posted 4/20/2018 10:38 PM (GMT 0)
biopsies aren't fun, but most of us get through them with minimal trouble. It's the fastest way to know for sure.

and even if the worst is true, you've got lots of options and every chance of a positive outcome.

Hang in there and keep us updated on your progress.

Andrew
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