Expert: Neha Dahiya MD - 9/23/2009

Question
I am 56 with a PSA of 5 ng/ml and PSA free .36 (I trust it means 36%, right?).  The tests were done according to Roche ECLIA Methodology.

Answer
Hello Ram:

PSA levels between 4 and 10 ng/ml are considered borderline. This increases the chances of cancer, however does not indicate that you have cancer as mild elevations are normal with age / benign prostate enlargement / prostate infection etc.

In borderline values to decide if a biopsy is required free PSA estimation is advised. There isn't agreement on this value but many physicians take 25% as the cut off.

For free PSA levels below 25% and a borderline PSA a biopsy is recommended.

At this point your results do not indicate any need for concern. This can be the baseline value and further evaluations will take this into consideration. It is advisable to continue having the tests from the same lab and on the same equipment to maintain continuity as there are minor variations in values between labs and equipment of different vendors.