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Total and Free Prostate-Specific Antigen (PSA)

Known as: Total and Free PSA
SKU: 266

95.00

Study material: Venous blood
Response time (working day): 1-2
The test is done on an empty stomach: no
Home call service: Yes
Country: Georgia

General Information

Prostate-specific antigen

(PSA) - Glycoprotein with protease activity. It is synthesized in the epithelial cells of the prostate gland and secreted into the seminal fluid, which ensures the liquefaction of sperm. PSA is present in the blood in minimal amounts and is found both free (free PSA) and combined with α1-antichymotrypsin (PSA-ACT) and α2-macroglobulin (PSA-AMG). 86% of circulating PSA is present in the form of PSA-ACT complex, only a small part of PSA is associated with α2-macroglobulin and is not determined during laboratory research, therefore the determined total PSA level is the sum of free PSA and PSA-ACT complex . With age, the total PSA level increases and the percentage of free PSA decreases.

  1. The total PSA test measures total PSA, including both bound and free-floating antigens.
  2. The free PSA test only measures PSA that floats freely in the blood and is not bound to another protein.

When should we take the test?

  • to determine the need for a prostate biopsy;
  • to monitor the effectiveness of prostate cancer treatment;
  • To detect recurrence of prostate cancer.

The prostate-specific antigen test increases the chance of detecting prostate cancer at an early stage. However, the routine use of the prostate-specific antigen test for prostate cancer screening in men without suspicious symptoms is controversial.

Men who have symptoms of prostate cancer (low back pain; pelvic pain; difficult, frequent, and/or painful urination) are often tested for prostate-specific antigen (PSA) along with a digital rectal examination (DRE). In patients who have been diagnosed with prostate cancer, the PSA test can help determine how advanced the cancer is.

Possible interpretation of the results

  • A higher ratio of free PSA to total PSA indicates a lower risk of developing prostate cancer.
  • A low ratio of free PSA to total PSA indicates a high risk of developing prostate cancer.

Reference values

What does an elevated PSA mean?
An increase in PSA can be caused by any prostate disease:

  • benign prostatic hyperplasia;
  • prostatitis;
  • Prostate cancer.

An increase in PSA can also be caused by factors such as:

  • urinary tract infection;
  • cystoscopy;
  • prostate biopsy;
  • surgical intervention on the prostate;
  • large prostate;
  • ejaculation;
  • examination of the prostate;
  • urinary retention;
  • inserting a catheter into the bladder;
  • Age (PSA levels increase with age).

Some medications can lower PSA levels. Such are - finasteride, dutasteride, antiandrogen drugs (flutamide, nilutamide, bicalutamide).
A low PSA level does not rule out prostate cancer. However, in general, the higher the PSA level, the higher the likelihood of cancer. A rapid or persistent rise in PSA, or rapid changes in PSA levels, further increases the likelihood of cancer. Prostate cancer is also more likely in men who have a low fPSA or a high cPSA.
The PSA test can help detect prostate cancer, but the PSA test alone cannot diagnose cancer. The only way to definitively diagnose cancer is a prostate biopsy. An increase in PSA in patients who have received anti-cancer treatment can be an indicator of recurrence.

 

How to prepare for the test?

  • Venous blood is needed. For 24 hours before the analysis, the patient should refrain from ejaculation.
  • 48 hours after drinking alcohol.

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This medical information is not intended to be a universal treatment guide for all patients. The treatment process, including the type, volume, and frequency of diagnostic tests and therapeutic procedures, is determined by the physician individually — based on an assessment of the patient's condition and relevant medical indications. The decision is made in consultation with the patient. Before purchasing a test, please read the instructions for its preparation.
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