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Is My PSA Level Normal? The absolute value of PSA has been the long-term standard of care to determine whether one’s PSA elevation is significant. Previously, the magic number of “4” was defined as being the upper limit of “normal.” However, this may not be a good rule of thumb since approximately 15% of prostate cancers can occur in men with a “normal” PSA. When interpreting a PSA value, several factors need to be taken into consideration—not just the absolute value of the PSA. Some of these factors include: Age adjustment of the PSA PSA density Percent free PSA PSA velocity Age-Adjusted PSA Recent data has redefined the way that urologists look at PSA, and what is considered a "normal" PSA. Age-adjusted PSA values take into account that a 40-year-old should not have the same PSA as an 80-year-old. Accepted age-adjusted PSA rates are below 2.4 ng/ml for men under...
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...
Who says you're too old for knee surgery to reconstruct a torn anterior cruciate ligament (ACL)? Doctors Miller and Sullivan recently reported on a rancher who had a successful surgery on his ACL. Nothing new, right? Except that the patient was 84 years old at the time of surgery. Surgery to reconstruct a torn ACL is usually only done on younger patients. Most doctors consider 40 to be old for an ACL surgery. The authors were unaware of anyone older than 62 having this type of surgery. According to the doctors, the patient had been trying to get along without surgery, but ranching was too much of a challenge. Walking around on the uneven ground caused his knee to give out on him. Rather than change his lifestyle, he opted for surgery. The surgery was a success. Three months later, the patient was back to his normal activities. When he went back to the doctor for a six-month recheck, he had full knee movement and near normal strength in his leg muscles. He also scored nearly 100% on a qu...
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