PSA dropping and % free ratio rising - why?

[Mike58]

OK, so as you can see from my Bio, I live in Australia and was due to start my HT this month. However, on Dec 5th, we decided to do another PSA test and surprisingly it had dropped from 8.1 in July to 4.9, so I thought maybe we should get another MRI to see what is going on. I had the MRI only a few days ago and so am waiting on the results, which should be available when my RO returns from holidays on Jan 4th.

But I thought I might do another PSA test in the meantime but this time add the Free psa % ratio to the mix (we didn't do that in early Dec)

So then my latest PSA test came back 4.74 and 12.7% free psa ratio. My original PSA in July was 8.1 and 7% free psa ratio .... The higher the Free % psa ratio the better the result.

So here is the data (Not sure if the same measuring system is done in the USA)

1: July PSA 8.1 7% free psa ratio

2: Dec 5th PSA 4.9

3: Dec 29th PSA 4.74 12.7 % free psa ratio

No treatment has started. Now I know that the MRI results is the key to really knowing what's going on, but nonetheless, can I at least take a little comfort in the above data and perhaps enjoy the New Year's celebrations?

I really hope that you all enjoy the end-of-year celebrations, keep safe and we trust that 2024 will be a good one for you all.

[Justfor_]

Your free PSA practically stayed (quantitavely) the same. July -> 0.57 vs December -> 0.60. Your total PSA went down. One reason can be prostatitis another anything that you started taking in the interim period, Avodart a good example.

[Mike58 in reply to Justfor_]

Thanks for your quick reply.

No not taking any meds at all. Zero.

I’m not familiar with your data about Free PSA. It’s not used here.

The screenshot I’ve attached shows on my report about interpreting free psa ratio.

Screenshot

[Justfor_ in reply to Mike58]

Free PSA is measured as an isolated quantity, using the same analyzer and units -but by a different assey- as total PSA. The free/total ratio is NOT something directly measured, but derived (calculated) by dividing the two measured quantities. Hence, the difference in your ratio doesn't mean much/anything, it is the decline in your total PSA that causes/modulates it and thereto you should point your interest/queries.

[Mike58 in reply to Justfor_]

Thanks for that. I guess in looking at my figures you kind of hope that there is something positive in them. I might be wrong, but from what I can gather, once the PCa gets out, then in most cases the PSA will rise, not decline. So here's hoping that because my PSA has declined by 40% in the last 6 months without any treatment, that hopefully the PCa is still contained.