Brief Answer: Furnish your Prostate problems in great detail Detailed Answer: Hi there, Thanks for your query. Firstly, I am not conversant about the fee structure in your country. However, the concerned Regulatory Authority must have issued strict legal guidelines for ALL doctors, regarding their consultation fees, depending on their qualifications. You are well within your legal rights to complain to the Medical Regulatory Authority, against the concerned doctors if you feel that you have been cheated. It is a standard practice to do PSA test- along with Digital Rectal Examinations (DREs), after 50 years of age, as a screening test to detect asymptomatic Prostate Cancer. YOU HAVE NOT MENTIONED YOUR PSA TEST VALUE. Further, PSA test is NOT diagnostic of Cancer, as it can ALSO be elevated in Acute Prostate infection (called Prostatitis); age-related, benign (non-cancerous) enlargement of the Prostate (called Benign Prostate Hyperplasia); or, Urinary Tract Infection. Please note that studies have shown that 25% of men with an elevated PSA level turn out not to have prostate cancer. As a universal practice, if the PSA level is found to be high (more than 5), the doctor * carries out DRE to see for a lump (enlarged Prostate) or features suggestive of Prostatitis; * gets urine test done to exclude/detect Urinary Infection; * if either Prostatitis or UTI is detected, a course of suitable antibiotics is prescribed to eradicate it completely. * Thereafter, it is recommended to continue with PSA tests and DREs at regular intervals to watch for any changes over time. If the PSA level continues to rise or if a suspicious lump is detected during a DRE, a prostate biopsy is required. I would therefore request you to kindly specify- in as much details as possible- your Prostate problems, to enable me to address it scientifically and also guide you as a thorough professional. I would be looking forward to hearing soon from you. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal

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Brief Answer: Prostate is removed ONLY when cancer is detected Detailed Answer: I am an Internal Medicine Specialist and have more than 30 years' experience of managing ALL urological conditions. The standard practice of recommending PSA test is also being followed in India (my country). I fully agree with your doctor that PSA test is non-specific, but only suggestive, as already mentioned in my earlier answer. Prostate is NEVER removed UNLESS cancer is confirmed by biopsy. So, the question of removing prostate, as a matter or routine, DOES NOT ARISE. You are probably referring to partial removal (in cases of BPH) when the lump significantly indents the urine pipe and cause kinking, which obstructs flow of urine. It's a simple out-patient procedure, in which the protruding portion of the Prostate is removed. This procedure does NOT CAUSE any problems whatsoever. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Take care, Col (Dr.) Rakesh Karanwal

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Brief Answer: Welcome Detailed Answer: Pleasure is mine. All the best and, take care

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