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Does a blood and urine test rule out an occult infection,or can it be discovered in sonogram biopsy?

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Can an occult infection accelerate PSA levels to a total score of 26? Does a blood and urine test completely rule out an occult infection, or can it still be discovered on a sonogram biopsy? Can a rubber band ligation procedure, or a new hemmorrid, spike total psa levels from a 7 to 14 to 26 within a four month period?
Posted Wed, 22 Jan 2014 in Urinary and Bladder Problems
 
 
Answered by Dr. Manuel C See IV 2 days later
Brief Answer: Yes occult infection can cause PSA increase. Detailed Answer: Good Day and thank you for being with healthcare magic! Infection can increase serum PSA to 26 and surgery on the rectal area may also elevate PSA. It is very hard to say how much the PSA would increase because the body reacts differently to infection and inflammation. I would suggest doing a transrectal biopsy of the prostate since the elevation of your PSA is very high and the doubling time is very short and you may be harboring an aggressive prostate cancer. It is still best to get an early diagnosis for better cure rates. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.
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Follow-up: Does a blood and urine test rule out an occult infection,or can it be discovered in sonogram biopsy? 23 minutes later
Hi! Dr. XXXXXXX C See IV, Thanks for your reponse. If there is an aggressive cancer, would it have been detected on a digital rectal? Also, if it is an occult infection, wouldn't it be detected by a blood test? Can BHP also be attributed to such a spike? My dad's free % PSA continues to be greater than 25%. Isn't it unusal to have an aggressive cancer in the prostate, with free radicals continuing to be high? Can there sometimes be no known cause for such spikes in PSA? Thanks!!!
 
 
Answered by Dr. Manuel C See IV 9 hours later
Brief Answer: Digital rectal would only detect late prostate CA. Detailed Answer: Good Day! The digital rectal examination would only detect locally advanced cancers already. If the prostate cancer is already palpated through a digital rectal examination then it might be too late and it may have already spread. So an early aggressive prostate cancer would not be palpated but would steadily increase the serum PSA. Occult infection in the prostate gland can be localized in the prostate and would not show in an blood examination or blood culture. Like I said infection may increase serum PSA but we have to rule out the most dreaded condition that causes increases in PSA which is prostate cancer. The only way to determine if the increase in your serum PSA is due to infection, inflammation or cancer is by getting a biopsy done. The rest are just purely speculation and early treatment is still fundamental in any cancer treatment which would equal survival rates. BPH should not cause that high serum PSA. PSA elevations can be caused by a flu, UTI, prostatitis, sexual activities and ejaculation and cancer. But it is rarely to go above 20 for the benign conditions. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.
Above answer was peer-reviewed by
 
Follow-up: Does a blood and urine test rule out an occult infection,or can it be discovered in sonogram biopsy? 16 minutes later
Dr. XXXXXXX C Se IV, Thank you for taking the time to answer my questions so quickly! I appreciate it!!!! Here are my father's PSA numbers: mid dec 2013: total: 26, free psa 54% early dec 2013: total: 23, free psa 55% early oct 2013: total 9, free 45% oct 2012: total 3.2, frew 35.4 % Oct 2011: total 2.3 1.)Isn't it a good sign that his FREE % PSA is becoming higher, or it is no longer a positive in a case with such spiking Total numbers? 2.) Also, have you ever seen a case(s) whereby numbers jumped so quickly, even with excellent free %, and still turn out to be an aggressive cancer? 3.) I still feel that perhaps a hemorrid is to blame with this spike. My dad had that rubber band ligation procedure, in August, and the Urologist originally thought it was stemming from inflammation from this procedure. 4.) Can PSA numbers spike for no apparent reason? 5.) Can a sonogram detect a mass, or it still would be difficult to discern if it is BHP, infection, inflammation, etc.? Thanks!!!! T
 
 
Answered by Dr. Manuel C See IV 30 minutes later
Brief Answer: you may get a serum PSA this January. Detailed Answer: 1.) Free PSA is useful only on PSA ranges between 4-10 which we call gray zone PSA levels. That is the value of doing the free PSA and avoiding unnecessary biopsies. for PSA of more than 10 it is generally accepted to do a prostate biopsy since chances of harboring cancer that is aggressive is quite high unlike for prostate cancers with serum PSA in the 4-10 range. So to answer your question I would not consider the high free PSA as a good sign because for me and the current evidence free PSA does not have any use on PSA levels above 10. 2.) very high or fast doubling time would always be an aggressive prostate cancer unless proven otherwise. Most of the time that is the case where a spiking PSA would be the triggering factor to do a TRUS biopsy which would come out to be positive. Of course there may be some cases where spiking PSA would turn to be benign but these are few cases. 3. and 4) Surgery in the anus may be the cause of the spiking PSA but that was august and any inflammation on the prostate should have subsided by now. But again it is very hard to say what's the cause of the PSA elevation but we are trained to eliminate first the most dreaded condition which is prostate cancer. you may get a serum PSA this January and if it is still elevated then you can do the TRUS prostate biopsy. Usually we can find the cause of the PSA Elevation whether it is infection, inflammation or cancer but rarely do we see spiking PSA with no apparent cause. And of course to rule out cancer we have to get a biopsy sample. 5.) transrectal ultrasound and MRI are the two most commonly used imaging modality used to assess the prostate gland. locally advanced cancer may be detected by these imaging but not for early prostate cancers which is very hard to see on any imaging modality. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.
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