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...
In the 21st century, medicine has seen unrivaled advances, enabling patient care that includes finding cures for previously incurable diseases. Surgical intervention has moved into a minimally invasive platform, with illness being treated in manners that allows for rapid return to work. Patients in the U.S. are constantly benefitting from the technology that is available; as a result, the American people are living longer, healthier and more productive lives than ever.
Recent events that have occurred on Capitol Hill have threatened to change this. Since this is a urology blog, first allow me to address the United States Preventive Task Force (USPSTF) decision regarding PSA testing . Recently this organization has given PSA screening a “D” rating. The panel has advised against PSA-based prostate cancer screening for men of all ages based on the panel’s moderate certainty that the potential harms of testing outweigh the benefits of testing. The...
In a recent Op-Ed in the NY Times , a non-clinician PhD, announces another fix to the health care crisis. Lets do away with PSA testing and save the government a lot of money! Brilliant, or is it?
Most Urologists in clinical practice clearly remember those days when the wards of a Urology floor were filled with patients dying of prostate cancer. Patients laid in their hospital beds in severe pain from metastatic disease to bone or perhaps were being dialyzed several times weekly as a result of renal failure that occurred due to metastatic lymph nodes from their prostate cancer that would result in obstruction of the urinary tract. Many patients were unable to urinate, and required catheterization. This was a horrendous way to come to the end of ones life, being totally debilitated and succumbing to a slow, painful, torturous end of life. Surprising that the author of The Great Prostate Mistake would knock the use of PSA testing, especially since his fath...
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