If one has a high PSA, but no enlarged prostate or issues with urinary functions or sex, what is the real problem with a high PSA? Is it possible to have a normal healthy life with high PSA? This is a great question. First, let's review the normal range for prostate cancer . I commonly use the age-specific PSA which states that: men 40-50 years old should have a PSA less than 2.5 ng/ml men 50-60 should have a PSA less than 3.5 ng/ml men 60-70 should have a PSA less than 4.5 ng/ml men older than 70 should have a PSA less than 6.5 ng/ml A man will be referred to a urologist for an elevated PSA. There are 3 main reasons for a PSA to be elevated: infection prostatic enlargement (BPH) prostate cancer If there are any concerns that a man may have prostate cancer then a biopsy of the prostate will be performed. This is an easy, out-patient procedure that takes approximately 15 minutes. Certainly, there are men evaluated for a high PSA who do not have an infection, enlargement o...
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...
A 62-year-old patient had surgery to remove his cancerous prostate gland about 6 years ago. Two years after surgery his PSA started to rise and now his PSA is 4.6 ng/ml.
I hate to say it but, it is clear that this patient has failed surgery and has "biochemical failure." In other words, his prostate was removed but there is something in his body making his PSA go up and probably more cancerous cells in his body. Even though he feels fine, this rise in PSA is the only sign that his prostate cancer is trying to return. There are two places were cancer can return: 1) in the pelvis where the prostate used to be located, or 2) elsewhere in the body, suggesting that the cancer has spread. Unfortunately, this is a fairly common problem. Up to 30% of men will not be cured by surgery alone and they will have a rise in their PSA months or years after the prostate is removed. That is why it is crucial for men to have their PSA checked on a regular basis after treatment.
There are f...
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