Key Benefits

• Screen for prostate cancer risk by measuring total and free PSA.
• Spot abnormal prostate activity before symptoms, supporting early evaluation and referral.
• Clarify urinary symptoms by distinguishing cancer risk from benign enlargement or inflammation.
• Refine biopsy decisions using the free-to-total PSA ratio and age.
• Track PSA trends over time to flag rising risk or recurrence.
• Guide treatment choices during active surveillance, surgery, or radiation.
• Reduce unnecessary procedures by contextualizing PSA with age, exam, and MRI findings.
• Best interpreted with a digital rectal exam, risk calculators, and symptoms.

What are Prostate Cancer

Prostate cancer biomarkers are measurable signals made by prostate cells and their tumors that reveal what the disease is doing inside the body. Testing them in blood, urine, or tissue helps determine if cancer is present, how active it is, and how likely it is to grow or spread. These markers reflect core tumor biology: what cells secrete, which genes are turned on, and how DNA is altered or repaired. Some are proteins released by prostate cells, such as prostate-specific antigen (PSA, a kallikrein protease). Others are gene messages and alterations, including prostate-derived RNA in urine (PCA3), characteristic gene fusions (TMPRSS2–ERG), tumor DNA fragments in blood (circulating tumor DNA, ctDNA), and inherited variants that affect risk and therapy response (BRCA1/BRCA2). Used alongside imaging and biopsy, biomarker testing personalizes care: it sharpens decisions about screening and biopsy, estimates aggressiveness (tumor grade and behavior), guides treatment selection (for example, when androgen signaling or DNA repair pathways dominate), and tracks response and recurrence over time.

Why are Prostate Cancer biomarkers important?

Prostate cancer biomarkers are signals from prostate cells that show how active the gland is and how likely cancer is present. The main one is PSA, made by normal and malignant prostate tissue. Paired with the fraction that circulates “free,” these measures reflect gland size, inflammation, and tumor probability before symptoms, supporting urinary, sexual, and bone health. These tests apply to people with a prostate.

Total PSA is interpreted by age; lower values for one’s age and a stable trend are most reassuring. A common threshold is 4, though optimal tends to sit toward the low end of the age‑specific range. Percent free PSA adds context: higher percentages lean benign; lower lean malignant. Infection, ejaculation, and enlargement can raise PSA without cancer.

When total PSA is low, it usually means a small, quiet prostate and a low likelihood of clinically significant cancer; symptoms are uncommon. When percent free PSA is low—especially with borderline total PSA—it suggests more protein‑bound PSA from tumor cells, raising cancer probability even while a person feels well. Early prostate cancer is often silent; urinary trouble or bone pain appear later if disease advances.

Big picture: PSA biology links the prostate with immune activity, hormones, and the skeleton, and complements exam findings, imaging, and biopsy when needed. Tracking total PSA with percent free PSA over time refines risk, reduces unnecessary procedures, and focuses attention on cancers most likely to affect long‑term health.

What Insights Will I Get?

Prostate cancer biomarkers matter because the prostate sits at a crossroads of reproduction, urinary function, and systemic signaling. Tumor activity can echo into energy, bone health, inflammation, and longevity. At Superpower, we test PSA Total and Free PSA to track this interface between local gland biology and whole‑body health.

PSA is a protein made by prostate epithelial cells (kallikrein‑related peptidase 3, KLK3). In blood, PSA circulates either bound to carrier proteins or unbound (free). PSA Total measures both forms; Free PSA measures the unbound fraction. Prostate cancer often increases total PSA and shifts more PSA into the bound form, so the proportion that is free tends to be lower when malignancy is present.

For stability and healthy function, a steady, lower PSA Total with a relatively higher Free PSA fraction suggests intact epithelial barriers, less tissue turnover, and minimal inflammation or enlargement. Rising PSA Total or a falling Free PSA fraction over time indicates increasing cellular activity or architectural disruption—signals that the gland is less stable and warrants closer context. These markers are probabilistic, not diagnostic, and benign hyperplasia or inflammation can produce similar changes.

Notes: Age and prostate size elevate PSA. Recent ejaculation, vigorous cycling, urinary retention, catheterization, endoscopic procedures, or biopsy can transiently raise it. 5‑alpha‑reductase inhibitors lower PSA; testosterone therapy may increase it. Assay methods vary across labs, and obesity can dilute circulating PSA.