PSA, PSA Free Relevance When PSA Is Low

[PTvsPC]

In your experience, what relevance does PSA and PSA Free and % have on someone with a low overall PSA score?

My PSA score is 0.8 with 13% Free PSA. I DO have PCa and was diagnosed a little over 5 years ago with G3+3, but was upgraded last Dec (2021) to G3+4 with one core less than 5% G4 as observed by Dr. Epstein. He also noted some perineural invasion.

When I was first diagnosed, my PSA was 0.4 and has seesawed between 0.5 and 0.9 since, although since 2019, the scores have gone from 0.5 to the current 0.8 in .1 increments each time.

I'm also on less than 1mg of Finasteride which I've been taking for over 25 years, initially for hair loss, but continued since my diagnosis to keep the prostate small.

I realize that's a lot of backstory, but my question is this: at this level of PSA score, and considering I do have a tiny amount of G4 and PNI, do you think the PSA and PSA Free % are meaningful?

Thank you for your insights!

Paul

[Tall_Allen]

PSA is cut in half by finasteride. Free PSA is meaningless at those PSAs. Use mpMRI to monitor progression, not PSA.

[PTvsPC in reply to Tall_Allen]

Thanks for the reply! I do have an MRI scheduled for next week. I'll post results.

[tn12 in reply to Tall_Allen]

If PSA is cut in half by Finasteride after RP. Does it mean my husband's PSAs of 0.02 to 0.04 is 0.08 and needs to start radiation sooner?

[Tall_Allen in reply to tn12]

Finasteride does NOT cut PSA in half after RP.

[tn12 in reply to Tall_Allen]

Thank goodness, thanks for your reply