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Just had a routine blood test and it came back with a PSA of 4.3ng/ml. Brother had prostate cancer at my age(64).Percent free PSA was 9%. Velocity was .8. Referred to Urologist and he said % free PSA doesn't mean anything to him. I was stunned that he didn't think it was important to do a biopsy ASAP. I did research and found a test(PCA-3) that is much better than a PSA. Had the test done and it was positive for cancer. This test is not affected by BPH or prostatitis. Talked to the urologist and now he thinks I should have a biopsy. Don't trust this guy anymore and going for second opinion. Anybody have this experience?
PSA is not prostate cancer specific. A marginally elevated PSA result of 4.3 ng/ml is associated with PCa in a minority of cases. Free PSA results are no more accurate than total PSA results in diagnosisng PCa - probably less so. PCA-3 is no more accurate than PSA and IS affected by BPH and prostatitis. The claims made for PCA-3 are mainly made by the manufacturers and sitributors of the test and, to the best of my knowledge have not been verified by independent studies.
There is no certainty in the prostate cancer world.
The piece I wrote entitled PSA 101 may help you in understanding some of the basics.
I would like to respectfully disagree with you regarding PCA-3 and the independent studies. The studies at the website above is what doctors use for their research.
There are two basic issues that make PCA-3 unreliable:
1. The original studies required "vigorous massage" of the prostate gland. This is a non-scientific description of procedure. It is not only difficult to interpret - just what is 'vigorous' - but may also be difficult in practice to achieve consistency. Prostate glnads are different sizes as are the fingers of doctors.
2. Part of the calculation of the value of PCA-3 tests invovles the PSA values. Given their inconsistency and variability, such attributes are incorporated in the PCA-3 tests.
