Free PSA is made by a normal prostate, while bound PSA is made primarily by prostate cancer cells.
The usual rule is that if a man's PSA is above 4 (normal 0-4), the free PSA should be at least 18% of the total PSA. This rule usually holds for every situation except infection. The ratio of free PSA to bound PSA is the same for prostate cancer and infections (14). Exercise has no effect on PSA (15). If you have an elevated PSA blood test, your doctor will check your prostate and order a sonogram to see if you have a nodule that may be a sign of cancer. Most urologists recommend a biopsy done in their offices.
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