Prostate cancer/ PSA Level?

First of all you should be seeing a urologist not a GP and you don’t need a hospital for a DRE.

Second, doing an MRI after a biopsy is stupid.

Biopsies and scans to not cause the PSA to decrease and there is nothing you can do to decrease it.

You need to see a urologist. There is not enough information here to answer you.

Since BPH, prostatitis and other conditions may also be the cause of an elevated PSA, you shouldn't worry too much. If your PSA remains on the same level next time or is lower, you shouldn't need to have a new byopsy done at that time, perhaps only another ultrasound/MRI/DRI. If it's risen further, then your urologist may want to repeat the byopsy. I think you have the right to refuse. The faster the rate of increase is, the more likelihood there is of malignant causes. That's why repeated PSA tests alone might give a hint.

If your prostate is very enlarged (>40 cc), there is a drug called Finasteride, which shrinks the prostate. If your PSA level is caused by a benign enlarged prostate, it should start dropping after a while (up to a year) on this drug. If you have cancer, the PSA level is unlikely to drop. If your PSA level is caused by prostatitis, antibiotics may get your PSA level down. Again, it's unlikely to drop if there is a cancer. Ask your urologist if any of these may be viable options in your case, i.e. if your PSA hasn't risen wildly.

Hello,

In my opinion a small prostate cancer is like a currant in a plum pudding, - if you stick a needle blindly into a plum pudding, you may miss hitting a small currant.

This reference may help, (click and return) http://www.cancer.gov/cancertopics/factsheet/detec... See especially "other methods of diagnosis," towards the end of the article.

Also I think this one on MRI is good, although a bit technical, - http://www.umcn.nl/Zorg/Afdelingen/Radiologie/Docu...

A diagnosis of prostate cancer implies some pretty serious surgical-, X-ray-, radioactive seed-, or chemical intervention, all of these having probable side-effects afterwards. Hence the need to be quite sure before letting a surgeon loose on it. If this were a possible skin cancer, the threshold for surgically removing it would be much lower, - because of there being no likely surgical side-effects afterwards.

As prostate cancer treatments become more targetted, - more localized, - as medicine advances, there will become less and less reason to avoid prostate cancer treatment, (because of there being no side-effects following doing the new procedures).

There are some more expensive biochemical blood-tests which might help you decide, - you should ask your Urologist about this, in my opinion. These sub-sets are said to be more accurate, with less false positives.

The most modern, most targetted treatment for prostate cancer is probably "Focussed Ultra-sound," (July 2012). I think you should push hard for this!! The reference for it is is here, http://www.telegraph.co.uk/health/healthnews/92064...

I hope this is of some help.

Best wishes,

Belliger

retired uk gp

This is the reason that the US recommendations were just changed, and routine PSA testing is not recommended now. There can be many needless procedures that result from elevated levels, and there is no change in mortality for people who are screened versus those who aren't. Regardless, you may just have an elevated level and that may be "normal" for you. There is some variation in levels among different individuals.

prostate cancer is a very slow cancer most men die with it not of it. My husband did die of another cause - his was advanced when discovered, IF you do develop it they will have caught it early it should not make any difference to your life span