• question-icon

    What causes elevated PSA levels?

default
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
doctor
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:
1.age.
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
doctor
default
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,
etc.
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.
doctor
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
surgery.

You're welcome to clear any doubts.

Dr.Matthew J. Mangat.

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

Urologist

Practicing since :1981

Answered : 1897 Questions

premium_optimized

The User accepted the expert's answer

Share on

Recent questions on  Knee injury

doctor1 MD

Does methylpred mask a knee injury or can it actually fix the problem. I had a knee injury where I heard a pop sound followed by intense continuous...

doctor1 MD

Hello. I had a bad fall in my living room (carpeted) on 11/06/17. I wasn't dizzy. I tripped on a throw rug. I could not get up by myself so I had...

doctor1 MD

I fell a week ago I fell hard and injured my right knee. The knee is still sore but my calf muscles are now spasing and are very sore?

doctor1 MD

Hello. I am a 35-year-old female. I started noticing that my feet tingle and go numb when I sit down about 4 months ago. It began with my long...

doctor1 MD

severe constipation immediate relief
My husband has a knee injury and had been taking oxycodone for his pain. The medication has made him severely...

doctor1 MD

My daughter had a knee injury in soccer last night . The knee swelled up and was painful. Later that evening she fainted and her hands went rigid....

doctor1 MD

Hello, I have a knee injury for the past 3 years now and never got professional help. I got it playing soccer. To this day I am in pain constantly,...

Get personalised answers from verified doctor in minutes across 80+ specialties

188 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Questions Answered By Dr. Matthew J. Mangat
  • Q - What does discoloration on the penis head indicate?

  • Q - Is sexual intercourse after a varicocele operation risky?

  • Q - What does numbness in pelvic area after using weed indicate?

  • Q - What causes bowel and urinary discomfort post radiation for prostate...

  • Q - Is Moxicip advisable when on treatment for TB ?

  • Q - Suggest treatment for UTI and blood in urine

  • Q - Suggest treatment for intermittent pain in right testicle

  • Q - What do recurrent UTI and incontinence after TOT cystoscopy indicate?

  • Q - What do these below lab reports indicate?

  • Q - Suggest treatment for blood in urine, headaches and chills

backtotop2