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Prostate Cancer

I'm 53 years old
PSA  1.70 in Nov. 2010  (0.5 in mid-2006, 1.0  late- 2008)
Free PSA  21.2% in Nov. 2010
DRE found an asymmetric prostate,(one lobe somewhat larger and hard than the other)

I assume the less than ideal free PSAof only 22% would be a lot more significant if my total PSA were below than 4.0. I go to toilet frequently 2hrs/day and 2times/night Can't find a risk number for this combination of PSA, fPSA and DRE results.

Shouls I get a biopsy to find out prostate cancer?
Thank for your help.
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242579 tn?1252114771
Thank you for your question. A high free PSA has an inverse relationship with risk of positive biopsy. That is the higher the free PSA > 25% usually indicates BPH and lower free PSA < 7% usually indicates prostate cancer.

Prostate biopsy should be performed based primarily on the PSA and DRE results. Other factors to include would be the rate at which PSA levels rise (PSA velocity), family history of prostate cancer, and race or ethnicity.

Kindest regards,

Ash K. Tewari, MD

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