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About the test
What is this test done for?
PSA (Free), stands for free Prostate Specific Antigen, which is a blood test used for detecting the presence of prostate antigen in the blood of a male.
Why is it Done?
This is a special blood test that evaluates the presence and amount of a protein, an antigen, released from prostate gland. Usually, the protein released by prostate gland is present in the blood in two forms i.e. attached to albumin (protein) and in Free State. The antigen which is freely circulating (without getting attached to albumin) is tested. The test is done for diagnosing conditions like prostatitis, benign hypertrophy of prostate (BHP) or prostate enlargement and cancer of the prostate. It also helps in assessing the risk of prostate cancer in patients who have enlarged prostate.
When should it be performed?

This test is performed if

  • A male is presenting with complaints of enlarged prostate
    • A slow or weak urine stream
    • Sense of incomplete evacuation of bladder
    • Increased frequency of urination (especially at night)
    • Urgency of urination
    • Straining to urinate
    • Dribbling of urine
    • Hesitancy or difficulty in starting urination
    • Repeated urinary infections
    • Passing of blood in urine
  • A male above the age of 60 years, as a routine screening test
  • A male, who is detected to have enlarged prostate, the test is done at an interval of 1-2 years, for detecting early phase of prostate cancer
  • To monitor prostate cancer therapy
How is it done
A blood sample will be collected from a vein in your arm. No special preparations like fasting required.

The test result of Free PSA is evaluated as free : total PSA ratio and chances of prostate cancer is given in percentile with reference to age

Interpretation of test result:

  • Free:Total PSA <= 0.1

    • 50-60 years - 49.2 %

    • 60-70 years - 57.5 %

    • above 70 years - 64.5 %

  • Free:Total PSA 0.11 - 0.18
    • 50-60 years - 26.9 %

    • 60-70 years - 33.9 %

    • above 70 years - 40.8 %

  • Free:Total PSA 0.19 - 0.25
    • 50-60 years - 18.3 %

    • 60-70 years - 23.9 %

    • above 70 years - 29.7 %

  • Free:Total PSA above 0.25
    • 50-60 years - 9.1 %

    • 60-70 years - 12.2 %

    • above 70 years - 15.8 %

Other Tests
  • PSA
    • PSA levels  above 4 ng/mL indicate the possibility of prostate cancer or prostate enlargement
  • Prostate biopsy
    • Presence of abnormal cells indicate prostate cancer
  • Ultrasound of KUB
    • It is a non invasive test, in which abdomen and pelvis area are checked with a device called ultrasound
    • Enlargement of prostate on ultrasound indicate prostate hypertrophy or prostate cancer
  • Urine PCA3 test
    • It is a specialized urine test that evaluates the presence of fusion of genes that are present in prostate cancer cells
    • Positive results indicate prostate cancer
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