Are those data trustable? Repeat the test needed?

[blueskyabq]

If 2 PSA tests apart of 5 weeks, 1st one is 9.6 and the 2nd one is 3.8.  Are those data accurate?  Why they showed so much difference, what that mean?   Other possible problems? Is it worth to retest again?

Even a free PSA tested, but those PSA data seems untrusted? Then what will be free PSA data tested at the same lab being trusted?

If the next step will depend on those data, should anyone feel comfortable about it?
Thank you in advance for your time and advice.

[Ketan K Badani]

Many things can affect a PSA result beyond cancer including prostate infection/inflammation, catheter placement, colonscopy, recal examination, colitis, urinary tract infection, kidney stones, among many other reasons.  I would not dismiss the tests done, but perhaps make sure you don't have a prostatitis, infection, or another reason, and then repeat the PSA one more time once any infection issues are resolved.

[blueskyabq]

Thank you so much to response all my questions, it is greatly appreciated.  Your advices are very helpful!  

[blueskyabq]

About PSA test, for a man in early 50s, tests for the past 4 years were 1.3-1.4 range every year, not obvious elevated.  The last year tested form this range was 18 mo ago.

In Aug 2008, PSA shoot to 9.6, but was told that might be caused by DRE exam right after DRE (1 hour after).

The repeat PSA after 5 weeks, PSA=3.8;  free PSA=0.4, so %fPSA?PSA=11% (seems low)

Did PCA3-D, very low, 5.8.

Repeat PSA at other Lab, 4.01, this was 2.5 days after PCA-3 test (with prostate massage).

Dr ordered repeat test for PSA and free PSA (test after 5 days after DRE again), still waiting for the results.

DRE for 2 urologist, normal with enlargement.

My question for you is, for all those data, age, no family history of prostate cancer, not an African men. If this is a patient of you, what is your advice for him at the current time? Biopsy immediately or wait or what else need to be test to exclude other factors (what will be most like after you read all those data).

Your advice is very important for me.

Thank you in advance for your time and your help!

[blueskyabq]

Dr, one more question, this PSA test results really bother me.  As I mention, the newest repeat of PSA and fPSA show big difference again. PSA = 2.52, %fPSA = 8.79% (they use fPSA=0.25, but PSA=2.86). Why same blood sample, PSA test first, it was 2.52.  But when test for calculate %fPSA, they use PSA=2.86 (test a bit later when test free PSA?)

Now this PSA is lower again for, 3.83 2 weeks again.  SO in a bout 7 weks, PSA were like 9.6 to 3.83 to 4.01 to 2.52.  What are those data telling you? data not accurate?  other health reason?  

IF DRE or PCA3-D (with massage of prostate)  will affect PSA test results, how long after will be reasonable time to test PSA?

IF other reason caused data difference, what will be?  Travel? inflammation or infection will be most like? But again, no any antibiotic or any medication has been taken during this period time.

Thank you again to read my questuons and help me out.