PSA Free - Prostate Specific Antigen
Also Known As
Test Parameters Included
- Free Prostate Specific Antigen (fPSA) Concentration (ng/mL)
- Free/Total PSA Ratio (%) - calculated parameter for prostate cancer risk stratification
Department
Methodology
Sample Required
Preparation
* Avoid Activities that Can Temporarily Elevate PSA (Crucial): * Sexual Activity/Ejaculation: Avoid ejaculation for at least 24-48 hours (preferably 2-3 days) before the test. *
* Reason: Ejaculation can temporarily increase PSA levels in the bloodstream, affecting both total and free PSA, and potentially altering the ratio. *
* Digital Rectal Exam (DRE): If you are having a DRE, it should ideally be performed after the blood draw for PSA, or at least 2-3 days before the PSA test. *
* Reason: Prostate manipulation during a DRE can cause a temporary rise in PSA, affecting the ratio. *
* Prostate Biopsy/Cystoscopy/Prostate Surgery: Do NOT have a PSA test for at least 4-6 weeks (or longer, as advised by your doctor) after these procedures. *
* Reason: These procedures cause significant manipulation or trauma to the prostate, leading to a substantial and prolonged increase in PSA levels, which could invalidate the ratio's interpretation. *
* Vigorous Cycling/Horseback Riding: Avoid for at least 24-48 hours prior to the test. *
* Reason: Prolonged pressure on the prostate can temporarily elevate PSA. *
* Medications/Supplements (Crucial): * Inform your doctor about ALL prescription medications, over-the-counter drugs, and supplements you are currently taking. *
* Reason: Some medications can affect PSA levels: * 5-alpha reductase inhibitors (e.g., Finasteride, Dutasteride): Used to treat BPH or hair loss, these medications can significantly lower both total and free PSA levels. Your doctor needs to be aware if you are taking these, as the interpretation of the ratio may be affected. *
* Do NOT stop any prescribed medication without explicit instruction and close supervision from your doctor. *
* Infections/Inflammation: * If you have a prostate infection (prostatitis) or urinary tract infection (UTI), your PSA levels (both total and free) will likely be elevated. The test should be postponed until the infection has fully cleared, usually several weeks after antibiotic treatment is completed. *
* Reason: Inflammation causes PSA leakage into the bloodstream, potentially affecting the ratio. *
* Clinical History Required (Very Important): Providing a detailed clinical history to your doctor and the lab is essential for accurate interpretation of results. * Your Total PSA Level: The free PSA is meaningless without the total PSA. *
* Age: *
* Family History of Prostate Cancer: *
* Any Urinary Symptoms: *
* Previous PSA results and DRE findings. *
* Reason for the test: (e.g., elevated total PSA in the "grey zone", follow-up on suspicious DRE).
Schedule Report
24 Hours
Emergency Report
Yes
Frequently Asked Questions
Is fasting required for Free PSA test?
No, fasting is not required. The test can be performed on non-fasting samples.
What does Free/Total PSA ratio indicate?
Lower free PSA percentage suggests higher prostate cancer risk. Ratio helps differentiate benign prostatic hyperplasia from prostate cancer when total PSA is borderline elevated.
How does Free PSA differ from Total PSA?
Total PSA measures all prostate-specific antigen in blood. Free PSA measures unbound fraction. The ratio provides better diagnostic specificity than total PSA alone.
Can medications affect Free PSA results?
Yes, 5-alpha reductase inhibitors (finasteride, dutasteride) lower PSA levels by approximately 50%. Inform your doctor about all medications before testing.
What activities should be avoided before testing?
Avoid ejaculation, vigorous cycling, or prostate examination 24-48 hours before test as these may temporarily elevate PSA levels.
Test Description
Test Code
P16
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