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What is the difference between PSA and free PSA?

October 1, 2009
  • By Harvard Prostate Knowledge

About the Author


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Sonia Dregne
July 26, 2018

My husband’s PSA I 6.6 ng/ml and his free PSA is <=4.5 ng/ml, what does it mean?

Ali Zakaria
March 12, 2018

male 51
i have result for PSA(Total & Free) as follow:
Prostatic specific antigen total 1.58 ng/ml
Prostatic specifica antigen free 0.38 ng/ml
PSA ratio 0.24%
this mean that i have cancer ?
what should i do ????
please i need your answer

Terry Smith
March 9, 2018

I am white, male, 68. Rec’d lab results but no explanation.
Prostate Specific Ag (Total) 0.69 ug/1 0.00-4.10
Prostate Specific Ag (Free) 0.46 ug/1 0- 0.90
Free: Total ratio 0.67

What does it mean?

February 25, 2018

My total psa was 11 and free psa was 1.5. It has been ranging between 6 and 9 for months. I had a b9opcy almost a year ago and it was benig. What does this all mean

Selko Bişevac
February 21, 2018

Greetings, Iam 57 years old and my Tot.PCA was 2,64 in Jan.2017 and 2,93 in July, 2017 but, my last PCA values 3 days ago was; Total PCA:4,16 and free PCA:0,714 ratio is 17,2%. Now, I have been using antibiotic against prostatitis with the proposal of urologist for 3 days. Can you tell me your opinions and possible cancer probability. I will be grateful and Many thanks in advance for yr. kind promt.reply.

February 16, 2018

Greetings. I’m 57, my oldest brother was diagnosed with prostate cancer a few years ago. My PSA is 1.5 and the ratio is 11%, and the doc said I have Prostatitis. This was after a UTI that first occurred in August, then again in November and finally at the beginning of January. Which prompted my visit to a urologist. In all three cases of UTI the doc said they treated it improperly, with the wrong antibiotics or for too short of a time. Is a biopsy called for in this case?

February 7, 2018

hi, I am 43 years old, PSA=4.2 free PSA 7.2. No pain, infections or enlarged prostate. the urologist recommend MRI and biopsy. How many chances I have for cancer?

February 2, 2018

Can you please answer my question ?
I am a male 84 years old and my total PSA test was 4.51, my free PSA 1.53, CPSA 2.98 and risk ratio 0.34. Are these figures good or there is a risk for prostate cancer and I must proceed for a biopsy?

Thank you. 2nd Feb 2018

January 24, 2018

Forgot to say Biopsy done 1 year ago was negative for PCa.

January 24, 2018

One year ago did a prostate biopsy Total PSA 4.9 Free PSA ratio 21.
Today Total PSA 4.3 and free PSA ratio 10.4 . Have BPH and Chronic Prostatitis.Taking Duodart. What should I do?

January 19, 2018

Dad is 69

Total PSA
2014. 4.4,
2015. 5.5
2016. 6.6
2017. 7.9 – Dec
2018. 11.59. Jan

Total psa jumped by almost 4 points in a month. Is it possible? Though it’s done in different labs. He had pancreatitis and gallbladder removed in Dec (not sure if it made a diff) His free psa in 2018 is 17%. He will get the biopsy done soon.

Just wonder if you guys have any thoughts on this?

December 28, 2017

Hi, all guys with prostatitis, nice to see you guys here. It has been two years i am suffering from chronic prostatitis pain. what’s your good option to treat prostatitis, for me it’s herbal diuretic and anti-inflammatory pill. Hope to get your reply to help me treat it better.


Kerry Hanson
December 17, 2017

Her is my question:
PSA 4.89(4.25 60 days ago)
Free PSA 10.12%
60 years old
Do I need a biopsy?

December 10, 2017

I am 71 yr old
free PSA = 1.89
total PSA= 7.79
Do I need biopsy?
Thank you

nick cosa
November 17, 2017

I am a 69 yr.old and a have total psa 1.42 and free psa 0.22.What is this meaning?Thank you!

David Correa
November 16, 2017

Hello, My name is David and I am 65 years old. Back in 2011 i had prostate cancer with a gleason number of 8. It was treated with radiation. Now My PSA is 12.02 and my free PSA is 1.83. A biopsy was perform and out of ten core samples only one came back cancerous. Please advise as to what you believe my best treatment or next step is at this time.
Thank you.

October 24, 2017

I am 43 years old the result of my test are: Prostatic Specific AG is 2.72 ng/ml PSA-Free 0.71 ng/ml. What is the meaning of this? Thank you…..

awni hanandeh
October 23, 2017

free psa less than 1
total less than 1 also

what you think

billy bob bear
October 5, 2017

psa 5.3 free psa 26% whats yall thank boys

joel santoro
September 20, 2017

I am a 72 yr old male with enlarged prostate which I had for years.
I just did a PSA test came back as 5 and PSA free was 13% which puts me according to the charts 25 to 30% chance of having some cancer. I have no symptoms and no nodules on my prostate. Questions 1.would a enlarge prostate come back with a higher PSA reading and a less favorable PSA free rating.2. Does the enlarge prostate effect PSA free test?
3 What other less invasive testing can be done to detect if I have and aggressive cancer in my prostate. MRI, 4K score, PCA 3.etc. My plumbing is working just fine and i am reluctant to get a biopsy test, if there is a less invasive more accurate way. The problem is you can’t get a Straight answer very hard to make a decision. If we had a more accurate database based upon the size of the prostate and the patients age might be helpful. Thanks for your time

September 13, 2017

Husband had recent prostatitis ( August 2017) – third episode in last three years. He has a diagnosis of BPH. Recent DRE (September 2017) – firm and smooth prostate; PSA
8.5. Last PSA was in 2016 ( a year earlier) following prostatitis and it then was 4.5.
Free PSA percentage done for first time this September 2017 was 12%
Also free PSA in ngms/ml was 1.
UA normal, urine culture pending.
He has no symptoms at present. He is 67. No family history of prostate cancer or other. Indian ethnicity. Has been on Hytrin for one year and this recent visit he was also put on Proscar for BPH.
Please, please advise regarding his chances of having prostate Ca; whether biopsy is recommended as a next step or should he have other non-invasive tests first. Thank you! I am anxiously waiting to hear from you.

September 12, 2017

3.8 psa.. 18 per cent psa free.. what does that mean? 67 years old. Do I need a biopsy?

John P
August 30, 2017

Hello. Thank you for the site Q/A.

48 yoa, PSA Total 0.6, PSA Free 0.1, PSA %Free 17 L

How are two in the safe zone but % in the red?

Had physical earlier this year and Prostate felt normal.


August 22, 2017

If the ratio > 0.25 means small chances of cancer
but if < 0.15 means high chances of cancer

August 13, 2017

This forum is total bull$hit, as there’s no way to respond to an individual entry. Also, no one seems to respond to questions anyway!!!!!

Inam Bakhsh
August 8, 2017

Dear Dr.
I am 67.5 years male living in Saudi Arabia for last 4 decades.
I have a enlarged prostate and weak flow
Today’s results are as under
PSA free 1.328
PSA ratio 0.210
What does ratio mean a higher and is lower is better

I have twice Biopsy with no sign of bengin.
Kindly advise risk factors
Many thanks and best regards


August 3, 2017


Napo Teto
July 18, 2017

I am 68 years Old, my Total PSA recently spiked to 5.8 Free PSA = 14% PSA at that time.
My urologist prescribed doxycycline monohydrate for 10 days, 3 months after with no sex for the previous 3 days I had PSA checked again and came out 2017 July 5 PSA = 4.5 Free PSA = 16.2%
My Urologist wants to do an MRI Fusion Biopsy.
I would like to know the risks and if there is a better less invasive way to handle this. I am dead scared of infections that could result as a secquel to this procedure.
Thank you for a qualified opinion

Rob Hetler
July 6, 2017

Sadly in all the comments I’ve read there is no mention of diet as a way to improve prostate health. A plant based low fat diet can be beneficial. Check out for useful advice on prostate issues and other health advice.

Mike M
June 22, 2017

64 years old white male. May 2017 PSA was 7.6. Doctor sent me to Urlogist. July 16 PSA 8.4, Free PSA 9.7. Next step biopsy? Any advice would be appreciated

Barry Jagodnik
June 17, 2017

75 years old white male:My PSA over the years has bounced around 4.5 to a recent 7.15. I have an enlarged prostate and have UTIs too frequently.I do have prostatitis. I was concerned when I reached the 7.15 PSA.First time it was a UTI.It has remained at this level over time.My MD put me on a 3 month antibiotic therapy to suppress my UTIs along with a monthly urine culture,Still, my PSA remains in the 7.15 area.My free PSA is 25.7%.My urologist advised me to wait 6 months and do another PSA test.All of my recent history IMO was negatively affected by a severe UTI from a catheter(Foley) which spread to my kidney.I trust my doctor’s advice.

Mohamad ayyash
June 12, 2017

I’m 40 yrs my total psa is 2.55 and my free psa is 0.33 what is that mean?

R R Rushing
June 12, 2017

age 66
Free PSA 0.545 ng/ml
PSA 3.6 or < 4.0 ng/ml

last two yearly test were 2.5 and 2.3 for PAS first time for Free PSA

June 2, 2017


A free PSA of zero? I was told that fPSA is always detectible. Did you figure out if this was an error? Best of luck.


May 8, 2017





May 7, 2017

Hi there,
I AM 53.
FREE PSA showed at 0.373
Ratio -7.49
my doctor recommends to have -2 proPSA test before biopsy.
What is a possibility that I have PC AS OF NOW.

April 28, 2017

i have
PSA of 12.955 ng/mL
Free PSA of 4.668 ng/mL

and Free/total PSA ratio of 0.360
can you please tell me what does it indicate?

Madhusudan Jalan
April 19, 2017

Hi aim a man age 59 years I have Total PSA serum is 12.67 and free PSAserum is 1.24 so pl advice what to do

March 29, 2017

Why don’t you have responses to these questions? It’s a waste of time without answers.

March 22, 2017

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Shaban Zayed
March 7, 2017

Hi Iam man 53 yrs Old

PSA Total = 1.66 ng/ml
PSA Free = 0.974 ng/ml
Cut Off = 0.58

Is That good result ?

Angela Underwood
February 23, 2017

my husband is 56 – these are his test results:
2014 PSA 8.0
07/2015 PSA 12.3 Free 6.6
12/2015 PSA 13.1 Free 5.4
06/2016 PSA 15.0 Free 4.7
01/2017 PSA 23.4 Free 4.0

2 negative MRI’s and 2 negative biopsies

Your opinion please

February 16, 2017

I’m 62 yrs old and i just got this test back, what is it telling me
My PSA (Total) (ng/mL) 4.83
Free PSA (ng/mL) 1.47
Free PSA% (%) 30.4

Tuan Qtruong
February 7, 2017

I am a 55-year-old man. I had a total PSA and free PSA test .The result is as follows :
PSA, Free: 0.629 Reference Range: 0.00 – 0.500 ng/ml
PSA, total: 2.860 Reference Range: 0.00 – 4.00 ng/ml
PSA Free and Total ratio: 0.220

Would you please advise me if i have the risk of prostate cancer?
thanks in advance .I am looking forward to hearing from your advice/opinion.

January 28, 2017

I am 70 years old. My test results now are p.s.a (cl) :10.7 free psa (cl) :1.17 and freepsa/psa :10.9
I should say I had many tests during different years, but now my results are more higher than before
Would you please guide me?
Thanks in advance for the help

Randy Neal
January 27, 2017

Dang! What I was going to ask was… is a high PSA with small gland worse that high psa with the standard enlarged gland? I went in because my urology was slowing down a bit sometimes. Coffee seems to increase ‘urgency’ but slow down the flow… better flow without caffein as a general rule.

Randy Neal
January 27, 2017

I am 63 and started the test about 40 and never once passed less than 4. (4.5 to 6 etc) went thru the routine twice) age 60 12.5 age 63 24.2 no doctor ever suggested a biopsy until now! and none ever said the gland was anything but “small” Not enarged. In the mean time NBC news reported PSA is not a very reliable test at either end of the scale. Nobody came up with a better and more reliable test in 25 years?

January 24, 2017

I am 79 years old and test results are:
Total PSA 0.44 : Method ECL
Free PSA <0.07

Kindly advise if the result is OK or not.

Best Regards


January 24, 2017

I am a man 69 years old and conducted PSA test and the results are as follows:

PSA total is 2.1 and free PSA is 0.2

Kindly advise if the result is OK or not.

Your early reply will be much appreciated.


January 14, 2017

Hi I am 51 year old. I had test PSA on 2015 was 0.5 ug/L in July 2016 was 0.63 ug/L now in 11 January 2017 jump incredible to 34.6 ug/L . I am very worried about cancer and the size of my prostate volumen is 65cc test it few day ago.
In the ultrasound test say my bedded volume before go to toilet was 119cc and after 14cc .
Can you tell me can be cancer my doctor doesn’t know he want me to wait 4 weeks to check if my PSA go down.

James Barwell
January 20, 2017

If you ride a bike or had sex in 72 hours before testing have another test and do not do those things.

January 14, 2017

correction – meant to write “readings at 3 different times”

January 14, 2017

I’m prsently 55, living in Ontario Canada and would welcome your commentary comparing the readings taken at 2 different times:
>Taken on 9 Jan 2017 – PSA(TOTAL) 0.36 ug/L and FREE/TOTAL PSA 0.56
>Taken on 3 Mar 2016 – PSA(TOTAL) 0.33 ug/L and FREE/TOTAL PSA 0.67
>Taken on 1 Apr 2014 – PSA(TOTAL) 0.44 ug/L and FREE/TOTAL PSA 0.55
Same test facility used in all cases

My father was diagnosed & treated. Are the numbers stable, staying in the right range or creeping in the wrong range. (my GP’s not much on commentary)Thank you.

December 30, 2016

I am 51 years old.
My test results are PSA: 2.916
Free PSA : 0.750
Percentage FREE PSA : 25.72
Kindly advise management.
Thanks in advance for the help.
Jaya Raju

December 26, 2016

hello dear
psa (total) 1.22
psa (free) 0.18
f psa/T PSA 15

December 13, 2016

I personally feel people will keep asking even with no answer in plain lack of reliable available information from most doctors. They just look at your record and see how you can come back for more of nothing. I still have to meet a doctor offer a cure; try asking and see a blank look in reply…

December 2, 2016

There is no answer. Why do people keep asking?

billy willy
November 23, 2016

my psa is 5.2

October 31, 2016

My last test result here:
Total PSA 1.6
Free PSA 0.36
Index f/t PSA 0.22
Do I have to Biopsy?

A Hughes
October 30, 2016

What is normal for a man to be prostate cancer free? Thank You.

Rakesh Sharma
October 18, 2016

I am 60 years old man, live in Hong Kong . My PSA jumped from 3.5 to 4.7 in a span of 1 year. Free/ Total PSa ratio was 7% as result of which Biopsy was carried out with 10 needle samples. One of the sample showed that I am having first stage Prostrate cancer Ca Prostrate – T1c (T2a) Gleason 3+3, PSA 4.7. Please advise the best treatment with above results, I want to know if the removal of Prostrate by surgery is the best solution among all available treatments

adriana carrillo
September 30, 2016

It is possible obtains free PSA greater than Total PSA?

David Le
September 28, 2016

I’m 49 yrs old and always had normal PSA in the past but this year it spiked almost 4x see below. I went to see Uro and he said my DRE was normal and put me on 30-day Cipro antibiotics then retest again in October.
Looking at the PSAs between 2015 and 2016, it seems to double then double again, hence 4x. The PSA velocity tween 2015/2016 is very concerning. Can PSA double then double again within a year?

4/2013 = 1.69
6/2014 = 1.43
6/2015 = 1.77
8/2016 = 6.96

John Lee
September 19, 2016

My last few test result here:

Jan-15 8.9 33.9
Oct-15 8.6 36.0
Sep-16 8.2 39.1

Do I have to Biopsy?

September 8, 2016

What’s the purpose of this blog when NO ONE answers any of the questions!?

David Tweedley
August 29, 2016

Thankyou for all the information on this page.
I am a very fit and healthy white male, 64 living in South Africe, from British origin.My parents both passed on just on 80. I do not recall my father ever being found to have any Prostate issues in his life. He was, though a heavy smoker and passed on due to lung and throat cancer.
I have never touched a cigaret in my life.
It was discovered on my FAA annual medical that 2 years ago the PSA was 3.7
On my current bi-annual tests ( August 16) with PSA at 4.3,I have been advised to go for Biopsy after a rectal inspection, where I have not yet received a written report, but was very shortly advised that the Prostate was large and there appears to be a lump.
I then read your page and noticed that In the blood tests done, there was no PSA Free test, so I demanded this through my GP, where the resutls came out at PSA 4.6, Free PSA 0.33 and Total Ratio at .071.(These tests were done through a different pathologist, inside 4 weeks where PSA was 4.3 and then 4.6)
Based on your chart, I interpret that my risk is below 8%.
Would you based on these revised results after the physical inspection still suggest that I go through the Biopsy, or would you rather suggest, as I think I should do, do PSA and Free PSA tests regularly in 6 month intervals and see if the variations will motivate the Biopsy?

Mahmoud Nabavi
August 11, 2016

I am 64 years old man. I had my gall bladder removed on May 5th. Before that my total PSA and Free PSA tests showed normality. During above operation, they had to pass a tube to my bladder to urinate more easily.
On July 10th my total PSA was 18.8 and Free PSA 2.6.
On July 18th my total PSA was 9.47 and Free PSA 1.63.
On August 10th my Total PSA was 5.0 and Free PSA 1.3.

Should I undergo a biopsy?
I thank you in advance.

August 9, 2016

oh sorry im 50 years old

August 9, 2016

i am so sorry but my result is;

PSA 0.83

free PSA 0.1 what is risk of cancer?

thanke you

August 3, 2016

I’m 54 years old my PSA was 9.1 on 12/18/2015 and is 14.3 on 7/31/2016 Had MRI and they said I have BPH enlarged prostate but now they want to do a biopsy. I don’t want to do it cause from what I’ve read they want to just keep doing them in the future. Any thoughts on this???? Thanks Jay.

July 14, 2016

I’d like to see the response to the questions

arman micael
July 12, 2016

Arman Micael

I am a 41 year old male, single with the following PSA readings:


Please advise.

Thank You!

June 28, 2016

don’t ask any questions here, no one will ever answer

Manoranjan Das
June 28, 2016

I am a 41 year old male with the following PSA readings
PSA Total = 0.46 and a Free Total PSA 0.182 and free PSA/Total PSA ratio 39.60

my rectal is burning only daytime after bowel. Please advise.

ASIM Kumar Ghosh
June 27, 2016

I have made apsa test.reading is 8.15. As per Dr.advice free PSA test to PSA test done. Free PSA read 2.47% to total PSA read 0.73%.I think possibility of prostrate advise

B Gopalan
June 25, 2016

I am a 72 year old male with the following PSA readings
PSA Total = 9.94 and a Free Total PSA 2.05 and free PSA/Total PSA ratio 20.62

Since the results are on the border, is advisable for me to undergo biopsy? Kindly convey your considered opinion.

Thank you,
B Gopalan

B Gopalan
June 24, 2016

I am 72 yrs old and my PSA total = 9.94 and Free PSA=2.05 The ratio FreePSA /TotalPSA=20.62.Since the ratio is just on the border, is it advisable to undergo a biopsy test?

I will be thankful to get your cosidered opinion.
B Gopalan

May 29, 2016

I am a 44 year old male with the following PSA readings
PSA Total = 1.93 and a Free Total PSA 0.34 and free PSA/Total PSA ratio 17.62

Are this Ok?

In advance thank you for your feedback.

Subir Datta
May 17, 2016


My father is 78 yrs old. He had a total PSA of 10.9 around 1 month back. After visiting Urologist and undergoing medication for a month, the latest results are : Total PSA = 1.43, Free PSA = 0.248 and % Free PSA = 17.34. Pls suggest whether biopsy is required or not.

Dr Sharad Vijayvargiya
May 11, 2016

I undergo psa test result is Psa free 1.205ng/ml and free psa/total psa 23.39 % if it is normal range? Or

April 27, 2016

Hi all. Wish u all well. Watch Dr. Pankaj Naram and other Ayurvedic and Islamic medicine before going through any other harsh allopathic treatments

Juan Rojas
April 26, 2016

My total PSA was 5.74. After 1 months in cypro treatment Total PSA was 4.3 and free PSA=.7
Ratio of free/total PSA = 16.3 .
My age:67, Prostate size=59 cc.
It is unnecessary a biopsy?

Mobeen Jawaid
April 19, 2016

I am 37 years old man, During MRI of lower limb for another disease , it was revealed that there is a hypointense area in peripheral zone of my prostate. Doctor did DRE with normal results and check PSA level. Free PSA was 0.39 and total PSA was 2.1. doctor starter antibiotic for 1 month and after completion of course again did PSA , Now PSA level was free PSA .39, and total eas 3.1. Doctor did TURS and found that there are 2 nodules one is central zone size 1.8 x 1.4 cm and one in peripheral zone size 0.8 x 0.4 cm. Doctor again did DRE with vegetative results and also perform PSA what was again free PSA 0.36 and total PSA 2.76. Now doctor decided to do Biopsy through TURS. I want advise of any one. Is is cancer? and Is there any chance of infection after biopsy.
I am really worried about


Peter Rouse
April 14, 2016

I am a 51 year old male with the following PSA readings
PSA Total = 1.03 and a Free Total PSA 0.17

Should I be concerned with either of these readings?

In advance thank you for your feedback.

Solly Ngoasheng
April 12, 2016

My case is as follows: In 2012 June 11 I took a test and the result were as follows:
PSA = 3.43
Free PSA = 0.49
PSA/Total ration 0.142
In 2015 the result were the following:

PSA = 4.10
Free PSA = 0.54
PSA/Ratio = 0.131

What does this mean? Cancer?

All me
June 4, 2017

The same as mine. I did Mr I the result is highly cancer
and wait for biopsy

Jamie Morales
March 13, 2016

I am 70 years old.

October 2014, Total PSA 7.9 ng/mL, Free PSA l.62 ng/mL, % Free PSA 20.5%
January 2016, Total PSA 8.3 ng/mL, Free PSA 2.44 ng/mL, %Free PSA 29.4%

According to my doctor, my right lobe is larger than the left, but the prostate is smooth. I drink about 48 ounces of filtered water daily, but no alcohol. My urine is free of blood and my urination flows freely and on average 12 ounces or more per void. Usually I void about once every 4 hours during the day and once in the middle of the night, although on certain nights I don’t have to void at all. Lately, If I wait too long after first needing to void, I tend to leak. I’ve never had erectile disfunction. I am in good health, have never been on medication of any kind.

My younger brother (he is 65) had prostate cancer at age 63 and underwent radical prostatectomy the same year. His last PSA test, taken two months ago, showed a detectable level (I think close to 4.0 ng/mL). Now he is going to have further tests.

My question: should I request a biopsy? My doctor has not advised me to have one but I can’t help noticing the total PSA jump from 7.9 ng/mL to 8.3 ng/ml 14 months later. I am also worried about my brother’s prostate cancer. How important are genetic factors?

March 13, 2016

Prostate issues are inevitable for man of senior years or early for some.Sooner or later we will face the reality.We have to accept the fact and do our best to follow the advice of health pros like yr urologist.LEARN AS MUCH AS YOU CAN and adjust yr lifestyle accordingly.Eating healthy and organic,especially licopen rich tomato and tomato juice,selenium rich garlic ,broccoli,brussel sprout,zinc rich pumkin seeds HELP prostate health according to cancer researches.

It is better to see yr urologist regularly to monitor yr situation than asking advise from somebody else, because each patients case is different despite similar.Not all medical problems are solved by Scientists,doctors etc but medical technology is advanced over the years.Life is so short.We are born out of our mothers womb and will leave this world one day in our coffen leaving loved ones behind.So do yr best to enjoy this world but only those who believe in God and his messengers will be happy in hereafter.

Sujan Ghosh
March 10, 2016

3rd Feb 2016 plenty of blood came out with urine. Previously I was having sudden pain in my groin area. After the painless haematuria doctor advised for USG and PSA test. The USG shows Grade I enlarged Prostate. PSA 5.37. CECT of abdomen is normal. Doctor kept me on antibiotics and again on 9th March FPSA and PSA was done. FPSA was 0.114 and PSA was 1.47. I am 38 years old male. FPSA is 7.9 %. I am having Urinary Incontinence and little pain in lower abdomen. Can anybody throw any light whether I am having Prostate Cancer or else. My father at the age of 67 was told by some doctors that he might be having Prostate Cancer. I went through his medical records and found his PSA was 18.40. On 70 my father passed away. Biopsy was not done at that time as we were not aware of Prostate Cancer then.
Thank you for any kind of information.

C keller
December 18, 2017

It sounds to me like a kidney stone or small calculi. They enter your uretha and are very sharp! Thus, they cut and you urinate with blood in your urine. The pain is very sharp. What did it turn out to be.

March 4, 2016

I am 50 years old. I did biopsy four months ago and result was negative.

Current total PSA 6.13; Free PSA 1.01; ration of Free to Total PSA 0.16. Please advise what this means.
Thank you,

March 1, 2016

I’m 52 years old, and I still don’t understand the difference between T-PSA and F-PSA. And have no idea which PSA test the VAMC uses, but I do know my PSA levels been going up over the past five years. The lowest 2.6 and highest 4.1.

So, should I be really concerned?

March 28, 2016

Dear Rakhu I’m 52 also and was just diagnosed with St2 PCa( stage 2 prostate cancer) and my Psa levels were very similar to yours. Going from 1.1-2.2-4.2 in three yrs. Please get a biopsy, don’t let nobody tell you otherwise! This is for your peace of mind and Life!!!

Velicki Boris
February 18, 2016

Velicki Boris

T PSA is 3.13 ng/L

FPSA is 0,81 ng/L

How can I get % of FPSA

Are this Ok.

Thank you

mohammad abbani
February 15, 2016

i just made a PSA Free test and the result is:

1.244 ng/ml

iam 65 years old .Please advise me if the result is normal

and if not what should i do in this case

February 13, 2016

I am 69 years old my psa was 4 in two months it went to 6. my free pas was 15. do I need a biopsy?

February 13, 2016

I am 69 years old I had a psa of 4 in two months it went to 6. my free psa was 15. do I need biopsy? real worried!

John Piag
February 8, 2016

I am 56year old male
I have a total PSA @ 3.6
I have a free PSA @ .8
Does this indicate a risk for cancer ?

February 6, 2016

Have had several psa tests. I’m 60….last one was 3.8…down from 5.2 after antibiotics. Free psa 18.9%. Doctor just wants to check every six months….is 3.8 normal at 60?

Terry Sproule
February 3, 2016

Previous PSA 9.9; biopsy results: T2, Gleason 9. While
awaiting proton therapy was started on Lupron Depot (3 mo).
Adverse side effects (diarrhea 84 day and counting) have
caused a delay. Now, being concerned of what might be happening to my diagnosed cancer I requested a new PSA.
Results: total PSA = .2 with free PSA <.1 . Testor was not able to calculate %. My doctor was elated with the
low PSA, I'm not so sure. Can you offer any help here?

January 28, 2016

My Free PSA is 0.28 NG/ml and PSA is 0.7 NG/ml do I have prostate cancer or not. Please mail me. Thank you for all your support!

Brian P.
January 25, 2016

I am being followed by a reputable Urologist in Atlanta. My PSA info above. I echo the anxiety of grey area results and Doctor does not order biopsy. Especially when I have conflicting advice from doctors and cancer patient. My best friend, a surgeon, sees Urologist at his hospital. He is 50 YO with PSA 2.2 no family history of PC. Urologist Dr. X immediately orders his doctor colleague get a biopsy and they find Prostate cancer. My friend recommends I see the same Urologist. I have worriesome velocity of 1.3 to 2.4 in 12 months. He orders another PSA a year later it is 2.4. Does not order biopsy. I’m same age as my doctor 2.2 P cancer friend. My PSA stays stable at 2.4 for 12 months then jumps to 3.1 (34% increase), and 48 hours later take free test it shows 2.2. .4 and 18 (though I had sex day before test). Now here is the intersting part:
-Urologist in Miami says get biopsy now. Unequivocal. Based on age, PSA 2.4 and prior velocity. -Heart Surgeon friend says biopsy is inevitable and to get it now because he had 2.2 and Pcancer At same age of 50.
-Urologist heart surgeon went to says just test PSA every 3 months (huh??)
-Read above that “Many” doctors recommend biopsy if Free PSA Is 20 or below even with PSA BTW 2 and 4 and mine is 18.
-Chronic BPH can increase PSA but it is also correlative with Pcancer (that’s a difficult conundrum).
-I have anxiety – particularly when I get conflicting advice from two well respected Urologists, and read the public policy over diagnosis of PCancer debate slow growth and aggressive prostate cancers. The overall impression is that there are too many prostate removals when slow growth cancer represents large percentage of all P cancer dx. Yet 15% of Dx is aggressive and can kill within short time. Who wants to take that chance of being in that 15%?
-The inevitable biopsy test is compelling and strongly recommended by one Urologist who has seen all my results and knows my BPH history, but not by my treating Urologist. That’s a difficult inconsistency to reconcile.
-Anxiety out there? Yes. Frustration over the state of the science and the different doctors opinions. At the end of the day I can insist on biopsy, but even the biopsy is hit and miss.

Brian P.
January 25, 2016

I am 50 YO
Jan. 2013 to Jan 2014 PSA jumped from 1.3 to 2.4
Jan 2014 to 0ct 2015 PSA = 2.4 on three tests

Jan 18 2016 PSA 3.1

Jan 21, 2016 PSA 2.2 Free PSA .4 Free % PSA = 18

15 year History of Chronic BPH (Probable Acute in the last 5 years).

Overall question – % likelihood of Pcancer and if I were your brother, would you tell me to get biopsy?

1. What is the argument for biopsy in my case now? I read that free% around my level of 18 many doctors order biopsy.
2. Do you favor 12 needle or 18 needle biopsy?
3. Is the new MRI test for Pcancer available and reliable?

January 24, 2016

i m 64 years .my p.s.a.6.7 and free p.s.a 1,43 can i hv to go for biopsy?

michel abou
January 19, 2016

i am 55 years old from beirut my name is michel abou
i just conducted my annual test and the results shown are :
PSA 0.51

can i have an idea please of this test.

January 7, 2016

I have read every comment left here. I see alot of men with great concern and anxiety. I too have an elevated PSA. 6.8 was the first reading after my Dr did the DRE (digital rectal exam) and did not tell me to refrain from sex 48 hrs before the blood test. Turns out I found out that you should not have a PSA test if you had sex or ejaculation 48 hrs prior to the test and have had a DRE prior to taking blood. Anyway I was sent to a Urologist who I discussed this with and he advised me 1 week no sex and repeat the blood test. It then came back as Total PSA 5.3 a little lower….but he said I should not have that high of a score at the age of 56 and recommended biopsy that I have been putting off. My free PSA was good at 25% meaning the probability of cancer is lower but he still wanted a biopsy even though the DRE was normal too. I learned of a Dr now in Florida but started his practice in New York area……Dr Sperling….Do a google for him. He uses a 3t MRI to check for Cancer and if found and can be treated uses a laser to oblate it that is guided with the MRI. But the head nurse failed to answer 2 of my emails to her asking if the MRI can find small cancers like a trus needle biopsy could. I spoke to her once on the phone but failed to ask that question. My urologist nurse when I asked her said Insurance requires a biopsy first and thats all the answer I got. SOOOO confusing. I am with the hundreds of other men concerned about the PSA scanning results and my own family Dr told me before he did the PSA not to be alarmed if it was high but then sends me to a urologist….My family dr also talked about the controversy over screening and the anxiety it can cause. It makes a guy feel like the PSA testing is not the KNOW all of screening although Im sure it does. But then you hear of men with LOW PSA and still have cancers but the Drs tell you that some cancers will not affect the PSA….So again what to do. Eventually every male with get cancer of the prostate but its not always the cancer that will do the guy in it might be something else as we all age. Anyway….you can see the frustration here. Wish there was a Dr or Urologists that would comment here too.

Martin swarbrick
March 25, 2017

I went thru similar.
Do your research on how European’s approach this.

My advice , get a MP- MRI 3T scan have an expert analyse it before doing biospy
Also ask doc if template biospy is better then TRUS ( my research says it is – yes they put you out for it – personally I was ok with being put under vs a. Crow bar up my butt!!) but combined with MP-MRI the probability of getting a false positvie ( ie the test says you are fine when in fact you are not) is much reduced . If no cancer found with template biospy guided by MP-MRI them u can be more confident you are ok- for now!
Make sure u check with insurance thought– the reason MP-MRI is not discussed here in US is $$ related– in Europe cost of MP-MRI is a fraction of what it is here so insurance dont like approving it! again check all I say with your doctors ( get ar least 2 opinions one in europe if possible).

Mohamed Mabrouk
January 5, 2016

Mohamed Mabrouk
I am a man of 80 yrs old. I just had a Total PSA & a Free PSA test. The result has shown the following:
T-PSA Result is 13.08
F-PSA Result is 2.09

As I am a bit confused about this result so I would like to have your advice if I have a risk of a prostate cancer.

Grateful to give me your opinion about this result.

Waiting on your prompt reply.


January 2, 2016

I’m 48 my psa a year ago was 2.3 this year 3.6 I have frequent urination and some burning after urination was given cipro a year ago for same symptoms they went away but are back . Could this be prostrate cancer

January 2, 2016

i am 43 with positive family history of prostate ca .
my screening result is
T.PSA: O.50
please advise me about prevention of prostate ca & guide me about above results.
with great thanks.

December 30, 2015

Lots of people reported their PSA elevated and had to go for the endless biopsy. No one even doctor tells you that sex and ejaculation can cause your PSA rising. If your PSA elevates, you can stop sexual activities and ejaculation for at least three months and redo the PSA. The PSA will probably drop. If you see your PSA drops, you may think about the necessity of the biopsy, especially you had the biopsy before. The change of the PSA is closer related to men sexual activities and ejaculation. The more sexual activities and ejaculations, the faster the PSA elevates. It does not matter you have no ejaculation 48 hours before your PSA. The BPH and prostate cancer are closer related to man sexual activities and ejaculation. If a man does not irritate his prostate, how can it quickly become enlargement? A man who never marries such as a monk probably rarely has prostate related disease.

John Labib
December 29, 2015

My father has 74 years old , PSA result is as the following
Total PSA 10.3 ng/ml
free PSA 1.2ng/ml
ratio 0.12%
Ultrasound examination “estimated Prostatic weight is 100gm
pre voiding urine is 80 CC
post voiding urine is 40CC

Thanks for your advise as i am confused if there is a Prostatic cancer or not
Thanks , Warm Regards

Rajinder Kachroo
March 18, 2017

I am a 68 year old man and have free PSA .5 while as PSA total is 6.8. my prostate is giving me problem as I am not able to pass my urine properly and have too much of pain while urinating. Prostate measures 41x61x48mm. Full bladder measures 509ml, Post micturation residual urine is 201ml. I am also suffering from ulcer. There are three ulcers in my stomach

December 21, 2015

I am a man of 60 yrs old. I just had a Total PSA & a Free PSA test. The result has shown the following:
T-PSA Result is 22.07
F-PSA Result is 4.61

As I am a bit confused about this result so I would like to have your advice if I have a risk of a prostate cancer.

Grateful to give me your opinion about this result.

Waiting on your prompt reply.


December 21, 2015

tpsa: 4.61
fpsa: 22.07

December 17, 2015

i justas a PSA test on December 14,2015. I am 64.
The results are as follows:


Lab report says OUT OF RANGE 24 L

Can you help with any conclusions. Your cooperation in this matter is greatly appreciated.

Thanks so much,

Joseph Miller

Mohamed Ans
December 14, 2015

My father 61y old , PSA 19.4 , F PSA 7.4 &prostateis 45g is this catigury for cancer prostste

John S
November 22, 2015

My PSA climbed from 3.8 to 5.4 to 7.1 in two years. My free PSA was 9.8 and my father had prostate cancer, so I knew I was a cancer patient. The doctor ordered a biopsy but I refused, stating that it was barbaric use the same dinosaur method of detecting cancer that they used 50+ years ago. Urologists who learned the same techniques in med school while ignoring technology. Doctor said they would radiate if the biopsy was positive (which I already knew it was). I said no way to that as well.

Found a urologist in FL who performs a 3 Tesla MRI and an ultrasound. Showed EXACLY where the cancer was with no needles and possibility of sepsis or serious infections. Went down to Mexico and got treated by a method not allowed in the U.S. No biopsy, no radiation, no prostatectomy. The cancer is gone and I have full “manly functions”. Doctors here are barbaric and could care less that your quality of life gets destroyed!!

P. Vanapruk
November 14, 2015

I am 85. After several DRE, my Doctor diagnosed my case as BHP with percentage of FPSA/TPSA tests over a period of two years (2014-2015) sliding from 28 to 25 to 23 to 22 and the last one on 11/14/2015 was 21.2%(1.43/6.76). Do I need a biopsy?
Thanks for your kind responses.

George Gerges
November 14, 2015

I have 49 of age,My psa results:
Psa 0.61ng/ml
free psa 0.22ng/ml
Free psa/total psa 36
Can tell me an advice what I must do plz.
Best regards.

M Sorota
November 9, 2015

I am a 59 year old man, with an enlarged prostate. Currently taking Rapaflo. Total PSA 5.3 July 2015 – then 6.1 October 2015. Free PSA July 2015 0.8 to 0.7 October 2015. % Free PSA 15% 7/2015 to 11% October 2015. Total PSA 2.7 5/2010, Total PSA 4.7 6/2014, PSA 5.3 2/2015 I have had biopsy couple of years ago and came back negativeI am concerned and would consider any advise you can give me.

Terence Daly
October 28, 2015

I am a 53 year old male. a recent PSA test during routine physical came back at 4.1 following a 2.0 the year prior. I was referred to a urologist who retested the PSA and added a PSA free % test. PSA came back at 4.1 and PSA free % came back at 8.8. The doctor then biopsied and it came back negative. I understand that a prostate biopsy is only 40% accurate. I am still concerned. Any advice? Thank You

October 18, 2015

After having read all of these posts and being a fellow sufferer(watchful waiting)I have a number of observations to make.
1. All of the inquiries listed can and should be answered by your physician.
2. If you do not have confidence in your physician then you need to find a new one now!
3. There is a great deal of “FACTUAL” information on line including this website. Make note of the date of the article as new information is coming out all the time.
4. Stay away from blogs regarding personal experiences. Remember they are subjective and are not the best source for you to base decisions on.

In the end your course of treatment is your decision. Be informed.

October 5, 2015

anyone know what is the ratio in getting the of Prostate cancer in men?

September 26, 2015

I am a 62 year old man who was recently diagnosed with Parkinsons–am currently taking mirapex and levadopa (minimal improvement in broad range of symptoms). 6 weeks ago my internal med doctor referred me to a superb urologist due to PSA score 6.3 (previous score 5/14: 4.56). New blood work: PSA 5.3 and Free PSA 9%. DRE normal. Ultrasound: at least 3 nodules found in peripheral area. I am scheduled for biopsy under sedation (thank God) where I understand the uro will take 20-24 samples. Bacteria resistant strain in urine put me on a 10 day antibiotic regimen; and in addition a rectal culture. i have additional immunological concerns. I’m in very good medical hands but am worried, not scared. I’ve read that any Free PSA below 10% is indicative of aggressive cancer. Is this true? (There is no history of prostate cancer in my family.) If I get an infection as a result of the biopsy, how long is the window before I’m clear?

Carlos Coronado
September 24, 2015

For many years I suffer from prostate problems such as pain, poor urine flow, BPH, frequency and many more symptoms. I am a 69 years old man and PSA has always under normal levels. The last one was done a month ago. The results were as follow: Total PSA 1.5 ng/ml; prostate specific antigen(PSA), free 0.98 ng/ml; specific antigen (PSA) free 65%. What chances of getting prostate cancer do I have?
Note: 1. All my urine tests are normal
2. I am taking Flomax and Finasteride
3. I get prostate pain after each orgasm which last for more than a day
4. All DRE’S appear to be normal.
5. In the past I was recommended to undergo surgery to reduce the prostate size but I refused to do it

Please advise what I should do.
I am in despair, anxious and depressed for this situation

Steve Coetzee
September 18, 2015

Please be so kind to let me know if my number are a risk of cancer.
PSA 6.3
PSA % FREE 9.5
Truly will appreciate your thoughts.
Steve C

September 17, 2015

I’m 58 years old, and have had several PSA test done during previous years, increased from about 5.65 in 2011 to current of 10.74, on sept.8 2015, last week. Before that, it was approximately fixed around 6.7 during previous months and years. Ratio of free PSA to total PSA is 13.5℅ with a free PSA of 1.45. I Have had one biopsy operation about 1 year ago, Needle biopsy of prostate with diagnosis of benign prostatic tissue and no cancer. 40*47*61 mm are dimensions of prostate and regular size.Weak urine flow on occasion and occasional problems emptying bladder….
Any suggestions?
Thank you very much in advance your help.

Andrew Anderson
September 15, 2015

I’m 69 and have had several PSA test done, increase year after year from 4.8 in 2008 to current of 10.93, Have had digital exam which indicates enlarged prostate. Have had two biopsy’s 1 with 12 samples w/one sample indicating High Grade PIN. Second biopsy of 20 samples showed no cancer or PIN. Weak urine flow and occasional problems emptying bladder. On occasion a sharp needle like pain in the prostate region. Have never had a free PSA.

Any suggestions?

September 3, 2015

I’m 64 and had a PSA of 5.1 with a normal DRE exam.
Had another PSA and PSA free test 6 weeks later and my PSA was 4.7, with a Free PSA of 15.5
Should I get a biopsy or could I get a MRI with the same degree of accuracy ?

August 19, 2015

i am 63 years
my prostate is calsificate and shows bellow test
P.S.A =7.8
free psa ratio =0.78
please guide me
thank you
Best regards

J D Baca
August 15, 2015

I have a free psa 2.1. Should I get a biopsy?

April 21, 2015

I am 67 years old. Last 5 yr PSA’s (2 free PSA results included):

3.58psa / 17% free psa 4/2015 (Abbott Architect)
3.89psa 12/2014
2.73psa 12/2013
2.87psa / 18% free psa 12/2012
2.16psa 11/2011

High Anxiety here. Second appt with Urologist soon. Any guidance deeply appreciated. Thank-you.

Gary Johnson
April 11, 2015

I am a 60 year old male. A paraplegic for 29 years

I have a total PSA of 0.6 and a free PSA of <0.1. The prostate is hard.

Should I be concerned?

khalid qureshi
April 4, 2015

Sir 4 month before I come to realize that I have urine weak flow, so I consulted urologist, hr checked with rectum and disclosed very enlarged prostate, I went for total PSA and result was 19.780, he put me on cipro and cantiflow 0.4
After one month PSA reduced to 10 And now its 8.01 after 4 months, SME gym I have slight pain in prostate area when belt of trouser s tight.
I would like to have ur expert advise.
Best regards,
Khalid qQureshi

Dr. leo Karkas
March 31, 2015

I already did thank you

Dr. leo Karkas
March 31, 2015

Men over 50 are concerned about what they hear of the possibility of prostatic cancer. When to screen, when to perform a rectal exam and when to undergo prostatic biopsies and also at what intervals. Bad biopsies may give a whip to the prostate to develop CANCER.
When the PSA is in the gray zone between 4.00 and 10.00 there is no need for biopsies or medications if the free PSA level is not high and the ratio above 25.
One of the signs to remember for further investigations is the steadily rising PSA from yeah to year by one percent.
This is to say that anxiety in men should be controlled by good advice rather by extensive invasion of privacy. However trouble in urination and alike symptoms and abnormal values of free PSA and any ratio between the free PSA and the total less than 10 become a compulsory rule for screening and investigation.

Dr. leo Karkas
March 31, 2015

Men over 50 are concerned about what they hear of the possibility of prostatic cancer. When to screen, when to perform a rectal exam and when to undergo prostatic biopsies and also at what intervals. Bad biopsies may give a whip to the prostate to develop CANCER.
When the PSA is in the gray zone between 4.00 and 10.00 there is no need for biopsies or medications if the free PSA level is not high and the ratio above 25.
One of the signs to remember for further investigations is the steadily rising PSA from yeah to year by one percent.
This is to say that anxiety in men should be controlled by good advice rather by extensive invasion of privacy. However trouble in urination and alike symptoms and abnormal values of free PSA and any ratio between the free PSA and the total less than 10 become a compulsory rule for investigation.

Maurice H
August 23, 2016

I am fortunate that my father was healthy in that area which may explain why at 65 I have a P S A score of 1.2. Although I have genetics on my side I still do not smoke or drink, I swim 2-3 times a week, and I add Lycopene, Saw Palmetto, X
Zinc, and other supplements. I find Urinozinc with Beta Sitosterol a great find!

Gerald Carter
March 25, 2015

I recently moved and currently looking for a new Urologist. I am 66 years old and found a new Family Physician finally after a year. Both my Dad, brother, and a cousin had prostate cancer. I had two biopsies in the past, but were negative. I have also been treated in the past with Levo & cipro. My current PSA level is 15.9 and the FPSA is 4.0. Would a repeat biopsy be warranted at this time based on family history and current values? Both my Dad and brother have died, Dad from additional complications (80) and my brother at 60. Thank you

March 18, 2015

had my prostate removed in 2007….ORIGINAL PSA WAS 23.9 HAD PROSTATE REMOVED AND RADIATION TREATMENTS. then it started to rise after a few months to 3.8, luprin shot reduced…..second shot given and then after 0.0 in 2013 it finally budged to 0.05> now it is 2015 ….what are your thoughts? I am getting another test soon….does history tell you I am ok? Phil

March 11, 2015

My husband is 52, has been on fluctuating doses of testosterone ink for 1.5 yr. PSA last April 2.1- in July 2.8- in Feb the following yr-PSA 2.79- free PSA 0.51 and free psa % 18.3. Hx- dad had prostate ca. Bx scheduled 4/3. Nervous. Suggestions?

κουκακης ηλιας
March 10, 2015


Maurice H
August 23, 2016

You will get a lot of replied writing in that language not!

March 8, 2015

A 55-year-old man whose is free PSA and total PSA 0.31 ug/L and 1.5 ug/L respectively is concerning about if he needs to have a biopsy. Three years ago, three polyps were found out, and diagnosed that all polyps were benign. Therefore, that patient has PSA testing every year to make sure a biopsy is needed once those polyps become malignant.

So, could any experts here tell me if he needs a biopsy now?

Thank you so much!

March 5, 2015

My 83 yr old father has just been biopsied and diagnosed with prostate cancer. I learned his PSA was 10 at least 6 months ago and this 6 month check has jumped to 17. After researching and reading posts I am beside myself wondering why he was not biopsied long before now. I am in another state and my dear dad is a private person. He does not want me to go with him to his dr. Appt. after the scan happens next week to see if it has spread. I think he needs an advocate to say that he is important, loved and worth the treatment. Does anybody have any knowledge or experience that can help me ask the right questions to get the right care for my beloved dad.

Roger Smith
March 2, 2015

I was beenDx with agressive prostate CA in September, 2014. I have been on alternative treatment since then. No chemo,radiation or surgery.
My PSA then was 9.0ug/L,
Free PSA 1.2ug/L and
%Free PSA 14.0%.
Now on the 13/02/2015 the values are as follows:
Total PSA-5.1ug/L
Free PSA: 0.88ug/L
% Free PSA: 17.3%
Please can you explain these figures to me, am I going in the right direction?

Sandeep Gupta
February 26, 2015

I am 49 years old man. I have a total PSA of 5.07, and a free PSA of 1.11, and % free PSA of 21.89. Please advise whether I should go for Prostrate biopsy or not.

Azzam Jarrar
February 23, 2015

I am 64 years and my PSA is (3.98 ) and Free PSA is( .261) and PSA ratio is(.o7)
what is my next step should be.. thanks

Ron Davis
February 20, 2015

I am 73 years old and my PSA is 2.4 and my PSA free is 16%. My Prostate is moderately enlarged and should I be concerned and if so what is your suggestion on my next step. Thanks

Maurice H
August 23, 2016

Great score for your age. Under 4 and there is no need to worry about”Free”

Charlene Crosthwaite
February 15, 2015

My husband had a PSA test in Oct. 2014. Total PSA…7.06 with Free PSA of 19%. DRE showed prostate enlarged. Urinary and ED issues. Dr. prescribed Cialis 5 mg every other day and 0.4 mg Tamsolusin daily and to have test repeated in January 2015. Total PSA…6.84 with Free PSA of 13%. Husband is 75 years old. His older brother also had prostate cancer several years ago. Dr. never mentioned Free PSA, but gave another appointment for November 2015, 9 months from now. I think that is a big drop in the Free PSA. Am I wrong to be worried about the Free PSA result?

Maurice H
August 23, 2016

Unfortunately Ms C genetics is very strong with the Prostate. Father can easily give it to either or both sons! It stinks, but those are the cards we are sometimes dealt’ Hope he feels better!

February 5, 2015

Hi I had a psa test in January 2015 and it came back as 10.1. This was a total psa not free psa i. I had follow up total psa last Monday and it was 1.5. Can anyone explain?
Bit embarrassed to say but for first test I had had sex an hour before? Could this explain such a variation? I had a psa done 2/years ago and it was 1.7. I am 57 years old

Maurice H
August 23, 2016

No sex 24-72 hours before. That my friend is the rule! Your second test confirmed it. I didn’t have sex , and in Oct 15 it came in at 1.2. At 65 I am very happy with that number and you should be to! Stop worrying, as most men our age don’t come close to our numbers! Just remember, the schlong stays inside for 3 days prior😎

February 3, 2015

It must be a waste to comment, as there is no response to the forum submissions

Gary Hoga
January 29, 2015

I am a little confused. According to the article that preceeded this blog 2 speciic tests were discussed.

Total PSA
Free PSA

In a number of the comments posted I see reference to numbers for %Free PSA.

It has always been my understanding that Free PSA is expressed as a percentage of total PSA. i.e., .20 = 20% of Total PSA is free. Meaning if I had a biopsy done there is a 20% probabilty (according to the chart) that cancer would be found. Am I correct in my assumption?

Mark Oliver
January 29, 2015

hello, I am 47 and my PSA is 4.6, I am so scared and depress. I am schedule for a biopsy on Feb. 16, 2015. I have a history of prostatitis 8 yrs. ago. But then my PSA was .04. Any ideas wil be helpfully.

January 25, 2015

Hi, I am 42 years old. My PSA has fluctuated for the last 10 years between 1.9 and 3.2. The PSA was 3.2 and my free PSA % was 20.3% on 12/12/13, at that time the doctor prescribed levoquin and my PSA went down to 3.0 and my % to 26.7%. I still felt some discomfit and irritation in my prostate, so my doctor kept me on the levoquin for another 60 days. My PSA as of 1/21/15 is 2.6 (which I am very happy with), but my free % is now 18.8%, which is scaring me. I have never had any biopsies, my doctor has shied away due to my age and potential risk. However, now I am concerned, should I be?

Also, what is an Onotype DX test and would this be a good test for me to take?

Thank you for your help!

January 22, 2015

Hi, I am 65 yrs old and saw a urologist for hemospermia.that I had for about 2 months. He did a psa which came back at 5.3. It had been 3.5 about 18 months prior. He said to give it time. I returned in 2 months and the hemospermia seems to have cleared up . He took a new Psa after a DRE that was normal and the psa was 7.2. My Free Psa was 19%. His recommendation was to take 5mg of Proscar for 6 months and if psa does not go down at least 50% than a biopsy would have to be done. My concern is that the PSA rose so quickly in 2 months. I also have BPH. Size 65 grms. Is it ok to wait 6 months? Thank you

January 14, 2015

Hi, i,m 64 and 18 months ago my psa was around 0.70 for years and then 6 months it went to 2.1 and stayed there for 3 months now it went to 3.3 with a free psa of 0.4 ng/ml, 25% i have the normal symptoms of bph and my rectal is enlarged but smooth. I drink 2 gallons of milk a week and lots of eggs and cheese and dairy. Do i need a biopsy? Thank you

December 25, 2014

I have an enlarged prostate and PSA readings between 5-6.0 on average. My FPSA is usually about 1 and % varies between 16-22%. I am 64 and had one biopsy 4 years ago but want to avoid more! My last test had a crazy high FPSA reading a little higher than my PSA of 5.3 so my % is 100% meaning no cancer risk??!!! Could this FPSA be so high due to other factors like a mild infection etc. ..maybe a follow up test next month to see if FPSA is back to normal??
Thks for any advice.

December 19, 2014

Hi , iam 67 years , my psa diagnostic is. Total. 3.260. Free 0.88. Free/total. 27.0% laboratory of american university of beirut. Please let me know your opinion about this result. Espcially for free psa which was befor one year 0.78. Laboratory evarage up to 0.72. ,please is it bad indication. Thank you in advance ,best regards. Roni

Vijay Mahadeo Bartakke
December 18, 2014

I am a man of 71 yrs. old. RecentlyI had a Total PSA & a free PSA test. The results are:

PSA-Serum by CMIA 5.145
Free PSA serum by CMIA 1.54
Free/Total PSA ratio 29.99

I had undergone thrice TURP in 1996,1999 & 2009. With histopathological reports ware negative.

PSA concentration has remained elevated since 2006.

Please note that I had TURS guided Biopsy in Feb.2014. Which result was negative.

So I am very much confused and anxious. I am very grateful to have a advice and opinion about the results.

Waiting for your prompt reply.

Thank you,

Vijay M. Bartakke

December 10, 2014

I am 71 years old. in June 2014 my total PSA was 4.48 and today it was 4.05. The free PSA is 0.96 and the ratio is 23.73%.
Should I be concerned?

December 5, 2014

I am approaching 59 and healthy person. My latest test results were Total PSA of 2.33 and Free PSA of 0.44 (free PSA first time tested). My DRE check up with Urologist specialist was normal. My Total PSA over the years have been around 2.5 with little change apart from one case where the total PSA went up to 3.3 and down again to 2.6 and then 2.33. Shall I continue as it is testing once a year? My consultant reassuring that everything is normal. Also can diet help to improve results effectively? Many thanks.

November 28, 2014

I am 44 years old I have a total psa of 5.9 with a free psa of 0.8 and a 0.14 free psa ratio . I am confused please advise me of what this means

November 20, 2014

i am 53 years
my prostate is calsificate and shows bellow test
P.S.A =0.362
FREE PSA =0.154
free psa ratio =0.43
pls guide me
thank you

October 23, 2014

60 yo excellent health, fitness. lifestyle and diet. No meds except TRT since 2006. Annual DRE always completely non-remarkable.

2006 – 2012 PSA = 1.8
2013 PSA = 2.1 Free = .21 so 10%
2104 PSA = 2.8 Free = .28 20 10%

Active surveillance or biopsy here?

October 22, 2014

I am a man73years old and living in Iran .I had a total PSA and free PSA test .The result is as follows :
Free PSA 0.4
PSA 1.41
Free psa/PSA 0.28 ratio
Will you pleas advise me if i have the risk of prostate cancer?
thanks in advance .looking forward your opinion .
best regards : REZA

October 13, 2014

I live in Brazil, 58 years old, and my blood test revealed the following:
Total PSA = 0.76 ng/ml
Free PSA = 0.42 ng/ml
Free/Total Ratio = 0.55
GP’s NOTE: “Results suggest BPH: Free-Total PSA ratio > 25%. Send to urologist.”
Thank you.

Maurice H
August 23, 2016

Your honestly worrying about 0.76? Come on dude, is that really fair to all those on this site with scores of 5-10?

September 27, 2014

I am 71 and I was diagnosed with prostate cancer last December (Gleason 6; 1 core less than 10%). I have been taking Avodart for BPH for several years. My total PSA has been around 1.9- 2.5 for several years). The latest PSA test has the following reading:
PSA % Free= 28%
PSA Free: 0.39 (ng/ml)
The test result does not list the total PSA. Doing the math I calculated the total PSA as 1.39 ng/ml. Please confirm if my calculations are correct: (0.39*100)/28.

Thank you for your help,


September 2, 2014

I am 59 years old. I have a
TPSA of 4.38
FPSA of 14.8 What would you recommend
thank you

Howard Himelstein
August 9, 2014

I have just been diagnosed with Pca…My Gleason is a 3+3=6, T1c, Total PSA is .65, psad is .01, but my free psa is .11 and my PSA3 test is 58.4…I read in Patrick Walsh’s book that if you have a free PSA under 15, there is an almost certain chance that one’s cancer is the aggressive type. When I asked my doctors about that they told me not to be concerned as it doesn’t apply to my situation. Does anybody know why it doesn’t? Can’t seem to get a solid answer from my uros…

PS – just had an Onotype DX test and it came back at a good and low 15.

Samuel Tso
August 9, 2014

I am a 65 years old man.

I had my first PSA tested in Jun 2008 and the results were Total PSA: 5.8 ng/ml and Free PSA:1.17 ng/ml. U/S prostate (transretal) followed by Trus Guided Prostate Biopsy were performed within two weeks from PSA test. U/S showed enlarged Prostate gland measurement 6.1×3.4×4.1 cm (TDxAPxCC). There was mainly hypertrophy of the central zone, suggesting benign prostatic hyperplasia. No focal lesin is seen in the peipheral zone. The contour of the prostat gland appears smooth. Biopsy of the protstae gland was perfomred and the procedure was unremarkable.

More than ten PSA tests were conducted from 2008 to end 2012 the Free PSA fluctuated from 5.7 to 7.8 and Free PSA from 0.98 to 1.41. In Aug 2013 PSA went up to 8.48 and in Jun 2014 PSA went up to 9.59, the doctor suggests to peerform a Biopsy. I am very concerned to do another Biopsy and would be grateful to have your advice by return.

Thanks a lot.

10 Aug 2014

July 9, 2014

I am 72 years old and have been diagnosed with andenocarcinoma in one lobe of the prostate. The size of the tumor is 1.2mm with a gleason score of 6. I also have an enlarged prostate that has weakened my urine flow. This has improved after the Urologist put me on Lucrin hormone treatment for six months. I am on my second dose. I just had my PSA done and the total PSA is 2.35 with free PSA at 1.01 and a percentage of free PSA at 42.9. This high percentage is of great concern to me. Could the high percentage be as a result of the Lucrin hormone theraphy. My testosterone from Lab result is 0.20
Can you please give me your thoughts on the above. Thank you. Richard

Dr Safina saqib
January 22, 2017

Free PSA with > 25% have less cancer probability.

July 8, 2014

I am a 48 year old man. My PSA has been fluctuating over the past four months from 6.8 to 4.2 to 3.6 to 4.6. However, each of the four times I have been tested my “free PSA” has been 0. (Yes, zero). I have been to two nationally recognized prostate cancer centers in southeast Michigan, but no one has ever seen a consistent “free PSA” of 0. I have a biopsy scheduled in 2 weeks.

Any thoughts you may have would be appreciated.


July 26, 2016

What was your results of your biopsy

Robert Kocher
July 7, 2014

I have been having prostate and PSA exams since 2003. My PSA on the first exam was 4.2. The doctor did 12 biopsies found nothing and was diagnosed as acute prostatitis. I was given Levaquin for 10 days and started three month follow-up exams. The PSA went down to 3.1 in 12/2004 then spiked to 7.4 in June 2005. August 2005 more biopsies, found nothing diagnosis chronic inflammation and was given Cipro for 10 days. Resulting PSA went down to 3.4 by 11/2006 and was 6.3 in 12/2010. PSA then went to 6.8 in 08/2011. More biopsies, no malignancies again. PSA last test 06/2014 was at 6.9 up from 5.8 in January 0f 2014 and free PSA at 10% down from 11%. Doctor wants to do biopsies. I am inclined to ask for a prescription for 10 days and then have the PSA redone again in September. What is your opinion. I will be 67 in November. My father lived to 82 years and died of bone cancer.

September 26, 2016

Usually with recurrent infections an Urologist will prescribe more than 10 days of Antibiotics , 10 days is not good therapy .
I have taken 30 and 45 days of antibiotics for an acute prostrstatis.
And spent 8 days in Isolation in Hospital for an infection of the Prostate that I became Septic .

Tamika Givens
June 29, 2014

Is it possible to have the Free PSA Value higher than the PSA Value?

Ron Adair
June 27, 2014

I have a total PSA of 5.3, and a free PSA of .34, and a Percent Free PSA of 6.04. Can you advise me of the risk factor?

Thank you very much,


January 13, 2017

My husband is of age 42. Month back he got Urine infection n had Cipla for 7 days. After 15 days d PSA was 6.9. After 3 wks PSA 5.9ng/ ml free PSA .29ng/ml n free/total PSA 4.9%.
Will visit urologist next week.
Terribly nervous.

May 28, 2014

I am a man of 55 years old , I just had a total PSA & free PSA test , the result is as follows:
Total PSA is 3.232ng/ml.
Free PSA is 0.845 ng/ml.
Please advise me if i have a risk of prosate cancer.
Thanks in advance , looking forward your opinion,
Thank you,

Osama Qandah
January 26, 2016

Psa 9,1 and psa free 3,6 ng/ml can you help me to konw the result if I have cancer or not

February 12, 2017

fPSA &PSA can’t access prostate cancer solely.its not so easy to say…you will or you will not have…its basically the scoring system for who needs biopsy…and to prevent unnecessary biopsies…since your free PSA is high and total low….so u need PSA doubling time…PSA density…then one can say you need a biopsy or not…

Karl Isabelle
February 13, 2014

I am a man of 66 yrs old. I just had a Total PSA & a Free PSA test. The result has shown the following:
T-PSA Result is 73.50
F-PSA Result is 5.15

As I am a bit confused about this result so I would like to have your advice if I have a risk of a prostate cancer.

Grateful to give me your opinion about this result.

Waiting on your prompt reply.


mary rashad
November 10, 2016

Hi could you pls answer my question about my father he is 73 years old and his total PSA test was 4.30 and his free PSA is 1.50 and the risk ratio is 0.34 is that results good or there is a risk for prostate cancer and we must do a biopsy for him

December 28, 2016

Thr PSA and PSA free test are bogus tests for prostrate cancer. Do a PCA3 or a 4Kscore test.

February 12, 2017

its easy..your PSA is low…ie below gray zone…and your free PSA is greater then 62%…so u on safe side theoritically…but u do need measure PSA velocity…doubling time…PSA density…if greater then 0.15ng/ml/ml….then u dont need biopsy…

George Bassey
February 24, 2017

Your free PSA is low..between 0 and 10% increases risk of a cancer..pls have a biopsy done for confirmation.
Thank you.
Dr George Bassey

jack hall
June 3, 2017

T-PSA=48.6. Free PSA=9.12. %Free Psa=18.8
What is the probability of prostate cancer? Do I need a biopsy?

March 15, 2018

Man of age 75
Total psa.0.6 and free psa 208 n/ml
This mean having cancer???

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