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Question: I am a 55 year old male and was diagnosed with prostate cancer one year ago. this was detected by a biopsy.My XXXXXXX score was a 6 and a psa of 6.8. My most recent psa ( 5 days ago ) was a 6.2. I have had 2 biopsies and rectal mri and a bone scan. Only one biopsy detected cancer, all other tests were normal. I am scheduled for robotic surgery in 3 weeks. I am confused. I have consulted with TOP NOTCH urologists from NYC to XXXXXXX and everyone has a different approach. I have zero symptoms related to this cancer. Confused in XXXXXXX
Brief Answer:
Prostate cancer work-up
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Most cancers detected as a result of an elevated PSA or an abnormal digital rectal examination (DRE) are clinically significant cancers that should be treated in men with at least a 10-year life expectancy.
Tumors with XXXXXXX scores of 5 to 7 are considered intermediate-grade tumors.
A PSA greater than 4 ng/mL is considered abnormal.Both BPH (Benign prostatic hyperplasia) and prostate cancer increase serum PSA.
Percent-free PSA (free PSA/total PSA) is more rationale ,as
a lower fraction of serum PSA is free and not bound to serum proteins in men with prostate cancer than in men with BPH.
Given the possibility for sampling error(Only one biopsy detected cancer), a repeat biopsy(TRUS/transrectal ultrasound-guided needle biopsy ) is advised and is usually positive for prostate cancer in approximately 40% of cases.
A minimum of six separate cores, three from the right and three from the left, is advised, as is a separate biopsy of the transition zone if clinically indicated. Direct visualization by ultrasound or MRI assures that all areas of the gland are sampled.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Prostate cancer work-up
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Most cancers detected as a result of an elevated PSA or an abnormal digital rectal examination (DRE) are clinically significant cancers that should be treated in men with at least a 10-year life expectancy.
Tumors with XXXXXXX scores of 5 to 7 are considered intermediate-grade tumors.
A PSA greater than 4 ng/mL is considered abnormal.Both BPH (Benign prostatic hyperplasia) and prostate cancer increase serum PSA.
Percent-free PSA (free PSA/total PSA) is more rationale ,as
a lower fraction of serum PSA is free and not bound to serum proteins in men with prostate cancer than in men with BPH.
Given the possibility for sampling error(Only one biopsy detected cancer), a repeat biopsy(TRUS/transrectal ultrasound-guided needle biopsy ) is advised and is usually positive for prostate cancer in approximately 40% of cases.
A minimum of six separate cores, three from the right and three from the left, is advised, as is a separate biopsy of the transition zone if clinically indicated. Direct visualization by ultrasound or MRI assures that all areas of the gland are sampled.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Localized prostate cancer
Detailed Answer:
Hi,
MRI performed with an endorectal coil is superior to CT to detect cancer in the prostate and to assess local disease extent. The treatment options for localized prostate cancer (nodule;second biopsy with 12 cores with negative results) can be surgery or radiation therapy. There are currently no definitive studies demonstrating that surgery or XRT(external radiation therapy) provides better cancer control. The most significant complications associated with surgery are urinary incontinence and erectile dysfunction, which occur in approximately 5 to 10% and 14 to 30% of cases, respectively.
Wish you event less surgery.
Localized prostate cancer
Detailed Answer:
Hi,
MRI performed with an endorectal coil is superior to CT to detect cancer in the prostate and to assess local disease extent. The treatment options for localized prostate cancer (nodule;second biopsy with 12 cores with negative results) can be surgery or radiation therapy. There are currently no definitive studies demonstrating that surgery or XRT(external radiation therapy) provides better cancer control. The most significant complications associated with surgery are urinary incontinence and erectile dysfunction, which occur in approximately 5 to 10% and 14 to 30% of cases, respectively.
Wish you event less surgery.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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