PSA Changed

I am 50 years old had a PSA test -2- years ago and it was 0.9 today the number is 2.9 with .2 "free".  I have a history of some calcium in the prostrate and had  kidney stones twice.  I have an appointment in OCT w/ a urologist. Should I be worried? I read where if the "free" is less than 20% there is a good chance of cancer. Please advise.

Thanks in advance.

[Ash Tewari, MD, M.Ch.]

Hello Sir,

Free PSA is used to determine malignancy if the total PSA level is greater than 4 but less than 10. Generally with a high total PSA and a low free PSA could be indicative of prostate cancer, but PSA velocity ends up being more pertinent for you. Your PSA has risen approximately 1 point per year, literature states that a rise greater than 0.75ng/dl could be associated with malignancy. The appropriate action is to correlate with physical examination (digital rectal examination) and if negative wait for another few months and draw another PSA and calculate velocity, or if DRE is positive to have a biopsy. Right now is too preliminary to determine whether there is a "good chance" of having cancer.

Thanks!