Brief Answer:
Why don't we start with an ultrasound first?

Detailed Answer:
Hi and thanks so much for this follow-up.

I can see you got the PSA repeated. This is persistently elevated and means this is a valid result and needs to be addressed.

You may be feeling fine but the truth is if this were from prostate cancer, they are generally asymptomatic at the early stages. The best chance to get them cured fully is also at this stage. This makes persons to at times erroneously believe that they are well and need no further evaluation.

I understand your concerns about a biopsy. The only reason why I would recommend this is because it will provide great information to us on what to do next. Though an unfriendly procedure, I will truly recommend this. If you really don't still feel like, I will at least recommend an ultrasound but this might not replace the need for a biopsy.

In all, a biopsy is very much needed for definitive diagnosis and treatment. However, as I mentioned, even if this were to turn out as cancer, surgery would be unlikely unless the pathology report strongly suggests an aggressive tumor, if any.

I hope this helps and guides. I wish you well.
Feel free to follow up with me as you deem necessary.
Regards

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Brief Answer:
We have discussed these earlier

Detailed Answer:
Hi and thanks for touching on that.

We have talked about these values in the previous exchange. The high values are consistent with diabetes and chronic kidney disease as discussed in the previous exchange. There is no change that needs further new details at this time. If you, however, have a specific question or new concerns that you would like my address, I am happy to look into.

Look forward to hearing from you.

Also, what are your thoughts about the previous recommendations about the elevated PSA?

Kind regards

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