The measurement of bound and free PSA can help differentiate between elevated PSA levels caused by cancer from those caused by benign prostatic hyperplasia. The lower the ratio of free to total PSA, the higher the likelihood of cancer.
The percentage of free PSA is usually a factor in deciding whether or not a biopsy should be performed.
MRI is currently recommended by the National Comprehensive Cancer Network for patients with a negative result on prostate biopsy or those on active surveillance who are concerned about the potential for undiagnosed disease. Both MRI and CT scan can be used for staging information prior to prostate cancer treatment for evaluation of local disease and lymph nodes.
The identification of PIN in prostate biopsy specimens warrants further searching for concurrent invasive carcinoma, seeing that PIN has been shown to predate a carcinoma by at least 10 years.
Learn more about staging in prostate cancer.
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Cite this: Chad R. Tracy. Fast Five Quiz: Prostate Cancer Diagnosis and Staging - Medscape - Jun 15, 2021.