The WellMan Clinic News No. 6
Prostate cancer is something many men think about as we get older, and the lack of a national screening programme has been in the news this week.
It is the most common cancer in men. 1 in 8 men will get it, and if you’re Black, your risk is double.
In this issue we focus on the complex PSA blood test which is included as part of our executive health screening package, or you can have a specialised appointment for the assessment of your complex PSA alone.
As ever, if you have any questions do contact us.
🧠 What’s the Difference?
When checking for prostate cancer, the standard PSA test measures the total amount of prostate-specific antigen (PSA) in the blood. But PSA exists in two main forms:
• Free PSA – not bound to other proteins
• Complex PSA (cPSA) – PSA bound to blood proteins
The total PSA test measures both types combined.
The complex PSA test measures only the protein-bound form, which tends to be higher in men with prostate cancer.
✅ Advantages of Complex PSA Testing
1. Improved accuracy
• Complex PSA testing can better distinguish between prostate cancer and benign conditions like benign prostatic hyperplasia (BPH) or prostatitis.
• This means fewer false positives, reducing unnecessary anxiety and follow-up tests.
2. Fewer unnecessary biopsies
• Because cPSA more accurately reflects cancer risk, men with raised total PSA but low complex PSA may be spared invasive biopsies.
3. More reliable at moderate PSA levels
• The test is particularly helpful when total PSA is in the “grey zone” (4–10 ng/mL) — a range where interpretation is tricky.
4. Useful for monitoring
• Complex PSA may provide a more stable marker for tracking disease progression or treatment response over time.
5. Convenient single measurement
• Unlike tests that calculate a free-to-total PSA ratio, cPSA can be measured directly in one step, reducing the chance of laboratory error.
⚠️ Points to Consider
• Complex PSA testing is not available on the NHS; however it is available at The Wellman Clinic.
• While it improves diagnostic accuracy, it’s still not perfect — doctors usually interpret cPSA results alongside examination and MRI findings.
• The test doesn’t replace clinical judgment or shared decision-making about further investigation.
💡 Bottom Line
The complex PSA test offers a more refined and reliable method of identifying the presence of early prostate cancer than total PSA. Obviously, it helps reduce unnecessary biopsies and anxiety, particularly for men with borderline PSA levels. However, it’s one part of a wider diagnostic toolkit. Contact us today to arrange a test.
