Dear Dr. Motola,
Four years ago I had surgery for a left inguinal
hernia, which unfortunately resulted in uncorrected internal post-op bleeding
causing ischemia and subsequent atrophy to the left testicle. Until
recently, I've never had my testosterone level checked against the reference
range. I am 83 years old and in very good health. I am told the normal
reference range is 200 to 900, hence my question ... is 259 good or bad
and is it dependent upon both testes functioning? My PSA level averages
3.5 and DRE tests are always normal. I have BPH . I am sexually active but not
as frequently as in the past.
start to fall after age 40. Symptoms
associated with decreased levels include memory loss, mood changes, depression ,
increased fat mass, loss of muscle mass, and a decrease in sexual function. These
symptoms are also associated with the aging process. Many times patients may
experience some of these symptoms, h...
Dear Dr. Greenstein:
My friend ,who is in his early 50s, just got the results of his annual PSA test - it was between 4-5. The results of his previous 6 annual tests were in the 1-2 range every year, until now. His brother recently had his prostate removed due to cancer.
He now has to see a specialist. We are both very concerned, but should we be that worried?
First, I never tell people to worry before we have all the answers. In this situation, it is crucial to know if this man has any new voiding problems such as burning, slow stream or the sensation he is not emptying his bladder. These symptoms can indicate prostate inflammation, which can falsely elevate the PSA value. In those cases, a course of antibiotics are warranted and the PSA can be repeated after finishing the antibiotics.
If the PSA normalizes then this man can continue to have his prostate examined every 6 - 12 months. The physical exam is also very important. The discovery o...
Dear Dr. Motola,
If a person has a low PSA can you attribute this to any particular factor or factors? In other words are there any medical reasons for a low PSA? A friend told me that there has to be mitigating factors for this low score.
A low PSA is usually desirable as it will be associated with a lower likelihood of prostate cancer . Prostate cancer is not always associated with an elevated PSA as tumors that are very high grade may be associated with normal PSA . This occurs because high-grade tumors are very dissimilar to normal prostate, and as a result lose their ability to secrete PSA. Most often these patients will have very abnormal digital rectal examination. Patients taking Proscar or Avodart may often have low PSA values. This group of patients needs to have careful scrutiny of the interpretation of their PSA.
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