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Urology (Expert Forum)
PROSTATE AND PSA
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Doctor's Answer
by Kevin Pho, MD, Jan 12, 2004 12:00AM
, Jan 12, 2004 12:00AM
The major causes of an elevated serum PSA include:
Benign prostatic hyperplasia (BPH)
Prostate cancer
Prostatic inflammation
Perineal trauma
You not a progressively elevating PSA with negative biopsy. First, you want to exclude the other causes (i.e. inflammation). A transrectal ultrasound may help.
If the infectious causes are excluded, then repeat biopsies are prudent. Prostate cancer is often a multifocal disease and the sampled volume is small with a standard needle biopsy. Repeat prostate biopsies may uncover cancer missed on prior biopsies (10% in 2nd biopsies, 4% in 3rd biopsies).
You may also want to obtain a free PSA level. A lower percentage of free PSA is associated with cancer.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Benign prostatic hyperplasia (BPH)
Prostate cancer
Prostatic inflammation
Perineal trauma
You not a progressively elevating PSA with negative biopsy. First, you want to exclude the other causes (i.e. inflammation). A transrectal ultrasound may help.
If the infectious causes are excluded, then repeat biopsies are prudent. Prostate cancer is often a multifocal disease and the sampled volume is small with a standard needle biopsy. Repeat prostate biopsies may uncover cancer missed on prior biopsies (10% in 2nd biopsies, 4% in 3rd biopsies).
You may also want to obtain a free PSA level. A lower percentage of free PSA is associated with cancer.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
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