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    What causes elevated PSA levels?

Posted on Thu, 27 Jul 2017 in Urinary and Bladder Problems
Question: XXXXXXX 5 biopsy showed 2 of the 13 spots analyzed as cancer. One a 5% risk factor, the other a 10%. ademocarcinoma cTcNOMx, XXXXXXX 3+3 TNM stage T1c.
Dr. Hettinger, Urologist watching my prostate condition last several years recommends choosing between (1) Watch while taking finasturil: retest PSA in six months, then again in another 6 months: MRI if needed in 1 year.
(2) RapidArc radiation treatment if prefer: 5 day/week treatment for 8 1/2 weeks after a 4 month hormone prep. 90+% success estimated.

My Dr. Hettinger thinks the first suggestion is very low risk: only slightly in favor of radiation route based on my anxiety lever. "Do it and get it over with" philosophy(?)
Surgery, freezing, or pellets not recommended.

You opinion/suggestions??

thank you
Answered by Dr. Matthew J. Mangat 1 hour later
Brief Answer:
Need some more details.

Detailed Answer:
Hello XXXX
elcome to HCM.
As an Urologist, i can understand your concern.
You should send the following details:
2. PSA
3. blood reports. There is an option to upload reports on this page. You can utilize it to upload scanned images of reports.
4. any other medication.
Wish you well.
Dr. Matthew J. Mangat.

Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Matthew J. Mangat 2 hours later
Age 69 Height 5'5" 174 lbs
Do minor bicyling and arm stretches. Running option as per the past not allowable due to knee injury of long past that has caused joint deterioration.
Latest PSA was 10.7, has been as high as 11 some months ago.
No blood reports that have anything of note. All normal per two year regular exam testing done in January. Lipids, TSH, CBC, Magnesium serum, Comp metabolic panel,
Meds daily: Omeprazole 20 mg Bisoprolol/HCTZ 5 mg
Konsyl (psyllium) daily fiber (1 tsp 2X/day) XXXXXXX type daiy vitamin: One A Day 50+
Father had slow growth prostate cancer. Did not contribute to his death.
Answered by Dr. Matthew J. Mangat 7 hours later
Brief Answer:
Cancer prostate needs staging and treatment.

Detailed Answer:
Hello XXXX,

Your question has some more details,so that an expert opinion can be given.

With high PSA levels since last few years,the biopsy has been delayed.
The adenocarcinoma prostate-Gleason 6,definitely needs treatment.

Before considering treatment options,staging of your cancer is incomplete.
It will need a bone scan(whole body),with a MRI scan of pelvis.
This staging will help to decide, the exact extent of the cancer and decision
can be taken,about which treatment to consider.

Surgery is always better in the long term,if the cancer is localised.
But a radical surgery can be considered,only if your medical condition permits.
The surgery is a robotic radical prostatectomy.(total removal of the prostate).

The other option is a conservative treatment in the form of :
1. Radiation to the prostate gland.
2. hormonal treatment.

Only observation, is not an accepted approach,as the cancer will continue to spread. Later,you may regret having chosen this approach.
You definitely should be on hormonal treatment,even if you're not opting for

You're welcome to clear any doubts.

Dr.Matthew J. Mangat.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Matthew J. Mangat


Practicing since :1981

Answered : 1897 Questions


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