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Suggest Treatment For Prostate Cancer

Posted on Mon, 27 Apr 2015

Question: Dr I have been communicating with the oncologist,but glad to see you are available also.Went to MD(urologist)who has been following me for years,Psa high as 8 .5 yrs 5.1 last test Nov,2014, free PSA 22%. Currently lastweek had UTI ,severe problem urinating Given abtibiotics and Rapoflow,back to normal in one day.Last Oct seen at MAYO Clinic,MRI they suggested Fusion L4-L-5-L3, at that time blood tests revealed very slight calcium level over normal range. So currently DRE abnormal right lobe larger than left asymmetrical. Headed for MRI Monday April (,2015. So with higher calcium,which waqs tested one month later ,upper limits of Normal. all of this seems to point to a deadly outcome.Your opinion
age 65

Answered by Dr. Dr. P. T. Patil (9 hours later)

Brief Answer:
Needs to rule out cancer of the prostate.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have raised PSA with symptoms of UTI.

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) What is the recent report of PSA.?
2) Have you done ultrasound scanning of abdomen and what is the size of prostate with post void residual urine ?
3) Have you ever done prostate biopsy?

Abnormal finding of prostate on digital rectal examination with raised level of PSA is suspected to be due to cancer of the prostate unless proved otherwise by doing ultrasound guided biopsy of the prostate.

Please discuss with your Urologist regarding doing biopsy of the prostate .

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (3 hours later)

Thank you for the answer I will be getting an MRI in two days I will meet with the doctor to days after. My main fear is that he detected that abnormality with the DRE because of the UTIand I displayed the classic symptoms of prostate cancer.so I am assuming he wants the MRI first to see if there is any spread of prostate cancer he stated he will take the MRI before the biopsy. So I have read that when a person as the classic symptoms of prostate cancer andand abnormal DREit's indicative of late stage cancer. Does late stage mean T3, or T4 or both.

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
Prostate cancer is graded as Gleson's Score.

Detailed Answer:
Hello
Thanks for follow up.Grading of the prostate cancer is based on Gleson's Score reported on biopsy of the prostate ,

MRI will reveal any spread to bones or vertebrae which is considered to be advanced prostate cancer,

Please post the report of your MRI .
Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar