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Prostate Cancer

Free and Total Fraction PSA Test



I asked a series of question on Friday, June 22 titled "My Third Biopsy." One of The responses was that my next PSA should include a free and total fraction. My question is what is it and what will it tell me that the PSA doesn`t?


PSA is circulating in the blood in two forms - bound to a protein and free or unbound. For reasons that are not understood patients with malignancy tend to have a lower free fraction and a ration of Free. Total is at times helpful in determining which patients with an elevated PSA who have had a negative biopsy should have a repeat biopsy. I am sure your physician should be able to discuss this with you. I hope this information is helpful.

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Response by:

Martin I Resnick, MD Martin I Resnick, MD
Formerly, Professor of Urology
School of Medicine
Case Western Reserve University