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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes elevated PSA levels while suffering from Lyme s disease?

Ron age 67 dx with Lyme s disease 2002. Had antibioitics, treatment for almost 2 years, then antibiotics again over past 2 years for chronic Lyme challenges. PSA slowly rising over 18 years to 4.3 (fall 2016) and now 6.7. Normal prostate (for age) per exam yearly. Urologist wants biopsy and ultrasound. No night voiding or other bladder problems. No signs of infection per UA. Diagnosed with Waldenstrom s macroglobulinemia 10/15 and treatment started 2/16 when nosebleeds were recurrent. His numbers (hgb, protein, RBC, etc) are back to normal except IgM 3500 (was 10,000 2/16 and he had velcade,rituxin IV - now rituxin just every 2 months to maintain levels) We are cautious because Waldenstrom s has caused a deficiency in a clotting factor and he did have a large hematoma after removal of an abdominal (lower trunk on the side) lipoma 2/2015. Maybe it isn t a problem now but we are concerned re: possible risk bleeding with the biopsy...and if a biopsy is really necessary at this point. Side note: urologist is consulting with oncologist before scheduling the biopsy due to the clotting factor issue. Thanks for your input.
Wed, 26 Sep 2018
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Pediatrician 's  Response
Hello,

You are very well versed in this man's medical history. Are you his wife? I am sure you know that prostate cancer causes the PSA level to rise.

Even though his digital rectal exam is normal, his PSA level has been rising and is now of concern.

I think his urologist is correct and ultra-sound and prostate biopsy is necessary to find cancer that might be missed by digital exam.

His urologist is very knowledgeable and is giving excellent care to this gentleman.

There should be no waiting. As soon as it is safe from a bleeding standpoint, the urologist should do a biopsy.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Arnold Zedd, Pediatrician
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What causes elevated PSA levels while suffering from Lyme s disease?

Hello, You are very well versed in this man s medical history. Are you his wife? I am sure you know that prostate cancer causes the PSA level to rise. Even though his digital rectal exam is normal, his PSA level has been rising and is now of concern. I think his urologist is correct and ultra-sound and prostate biopsy is necessary to find cancer that might be missed by digital exam. His urologist is very knowledgeable and is giving excellent care to this gentleman. There should be no waiting. As soon as it is safe from a bleeding standpoint, the urologist should do a biopsy. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Arnold Zedd, Pediatrician