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What does PSA level of 20.6 indicate?

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Posted on Mon, 14 Dec 2015
Question: My husband has a PSA reading of 20.6 can you tell me how serious this reading is?
doctor
Answered by Dr. Panagiotis Zografakis (30 minutes later)
Brief Answer:
it's very high

Detailed Answer:
Hello,

20.6 is a very high reading. There are a lot of potential causes, including cancer, urine retention, prostatitis, etc. Since cancer is the most important of the aforementioned causes, it should be excluded with appropriate testing. A digital rectal examination, an ultrasound scan and biopsy of the prostate are good ways to detect it. A visit to a urologist would be the most appropriate next step.

I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (43 hours later)
Why does PSA go up? Would colon cancer cause the PSA to go up? Would Sildenafil medicine cause the PSA go up?
doctor
Answered by Dr. Panagiotis Zografakis (30 minutes later)
Brief Answer:
PSA increases mostly in diseases of the prostate gland

Detailed Answer:
The PSA rises in various prostatic diseases. Colon cancer may raise the PSA levels but not as much. Only a slight elevation can be justified. Sildenafil is not supposed to cause any rise but sexual contact is. A 20 is too high for this kind of etiologies though.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (12 minutes later)
What kind of test should be recommended other than biopoies to see why the PSA is rising? What kind of diseases would cause the PSA to rise. What can you do to lower the PSA?
doctor
Answered by Dr. Panagiotis Zografakis (3 hours later)
Brief Answer:
many causes of PSA elevation

Detailed Answer:
All conditions in and around the prostate may raise the PSA including prostate cancer, prostatitis, acute urinary retention, benign prostatic hyperplasia, prostatic ischemia, prostatic massage (digital examination, intense bicycling, etc), prostatic biopsy, indwelling catheter, etc.

Other conditions (unrelated to the prostate) may also raise the PSA, including tumors (colon tumor is one of them), drugs (testosterone for example but no sildenafil), acute renal failure, circadian rhythm, etc

You can't lower the PSA. You can only manage the underlying condition. If the underlying condition is properly managed then the PSA may get lower.

Other tests include the digital rectal examination and radiological tests (ultrasound scan and MRI).

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (55 minutes later)
My husband, at 77 is it wise to take treatments or have prostate removed, he is in good health and still works everyday, if so what should he do? His prostate is so small that they can not put seeds in it?
doctor
Answered by Dr. Panagiotis Zografakis (5 minutes later)
Brief Answer:
investigation is required

Detailed Answer:
Whether it's wise or not depends on the underlying condition. If it's just a prostatitis for example, a course of antibiotics will do very good to him. If it's tumor on the prostate then it all depends on the tumor's aggressiveness. Only a biopsy may give the urologist this information.

You can't judge by the age only. A slow growing tumor could be left alone or with conservative treatment only. Having an aggressive tumor though might be a good reason to do more than that.

So in conclusion, unless there is a certain diagnosis, nobody can tell you what's better for him.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3767 Questions

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What does PSA level of 20.6 indicate?

Brief Answer: it's very high Detailed Answer: Hello, 20.6 is a very high reading. There are a lot of potential causes, including cancer, urine retention, prostatitis, etc. Since cancer is the most important of the aforementioned causes, it should be excluded with appropriate testing. A digital rectal examination, an ultrasound scan and biopsy of the prostate are good ways to detect it. A visit to a urologist would be the most appropriate next step. I hope you find my comments helpful! You can contact me again, if you'd like any clarification or further information. Kind Regards!