questions about PSA tests

[blueskyabq]

What is PSA density?  For diagnosis, PSA+ free PSA is enough or cPSA+PSA is needed?  Which one will be more accurate?

Is Prostate enlargement mean DRE abnormal?

Thank you in advance for your time and advise.

[Dr_Veena]

Hi,
    Thanks for writing in. PSA is a protein produced by the cells of prostrate. PSA Iis produced for the ejaculate to liquefy the semen and allows the sperm to swim freely. Normal level is 0-4ng/ml.

For diagnosis total and free PSA are required  along with DRE results.
In case of enlargement of prostrate DRE results will be abnormal.

Free to total PSA ratio is important for diagnosis.
All the best.
I

[Menchu]

My boyfriend (age 51) has consistently high PSA, over 8. DRE showed no hard lump. Prostate biopsy showed only 1 of 12 points is positive. The urologist still cannot conclude if it is cancer. He mentioned zero stage.  His PSA is always at the range of 7.5 to 8.5

Problem of varicocele was found in his scrotum. Could this be the cause of high PSA?

Please reply.

Thanks.
Menchu

[Dr_Veena]

Hi,
     Thanks for writing in. The normal value for total PSA has been set at less than 4.0 ng/ml. There is agreement that patients with a total PSA level greater than 10.0 ng/ml are at an increased risk for prostate cancer.

Concentrations of total PSA between 4.0 ng/ml and 10.0 ng/ml are often referred to as the “gray zone.” It is in this range that the free PSA is the most useful. When patients in the gray zone have decreased levels of free PSA, they have a higher probability of prostate cancer; when they have elevated levels of free PSA, the risk is diminished. The ratio of free to total PSA can help the doctor decide whether or not a prostate biopsy should be performed.

Varicocele cannot cause a change in the PSA levels. Discuss with your doctor and get ratio of free and total PSA levels for your partner.
Best.