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prostate cancer psa

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Q: Prostate Cancer???
My dad is 84 Years old and He recently had a routine blood work and I had the results. Can you halp me to understand it? Results(Written by doctor Genreal doctor) 84 y/o male no regular medical f/u with elevated PSA noted on recent routine blood work (PSA= 14.99). On P.E. prostate enlarged 1 1/2 X's firm non-tender & nodules Pt denies SX's of hesitancy frequency. An urologist made a rectal test and said he probably has prostate cancer but that dosn't not matter anymore because he is 84. I'm not happy with that and i would like to have different opinions about it. This doctor told my dad to take DOXAZOSIN 2 Mg about six weeks. Does this indicate cancer symptoms?? Is it a good idea to do a surgery?

A: As a urologist, I note you are not happy with the information and recommendations you have received from the physicians for your father thus far, but it appears you were not with him when he had his appointments. What did they tell him, what did they advise him to do? The previous answers to your question are generally correct, but you should understand that the only way a physician can truly make a diagnosis of cancer is by obtaining a sample of the tissue in question and having it processed by a pathologist, who is a physician who has specialized in the diagnosis of disease by its appearance under microscopic magnification. A prostate biopsy is an office procedure, mine was painless, and the procedure takes only a short time, and local anesthesia is all that is necessary. In general, there is a low risk for complications, but nothing is free of risk. That said, with a PSA of 15 (upper limit probably 6) and a firm, non-tender, nodular prostate which is enlarged one and a half times normal, is strong clinical evidence for prostate cancer. So, assuming your father does have cancer of the prostate, it is not causing him serious problems it appears, from the standpoint of blocking the flow of urine from the bladder. Remember that the prostate surrounds the opening of the bladder in men and contributes to the semen when a man ejaculates. Therefore, blockage of urinary flow is a common local symptom of prostatic cancer. The Family Physician prescribed Doxazosin because he suspected there was probably some obstruction occurring. Treatment of prostatic cancer is an individualized decision that is based on a thorough medical history, phsical examination, appropriately chosen laboratory, x-ray, and other tests usually including a cystoscopy to ascertain what else is going on in the lower urinary tract of the patient. A urologist, who is a trained surgical specialist in the surgical and non-surgical modes of treatment of cancers of the urinary tract and the reproductive tract is most qualified specialist to render an opinion as to the appropriate treatment of a case of prostate cancer. Many factors are involved, but some of the most important ones are the general health of the indivudal, his general life expectancy, what other illnesses or conditions are present and once the patient has appropriate information from his physician, WHAT THE PATIENT WANTS FOR HIMSELF in terms of treatment. Prostate cancer, like breast cancer in women, is usually responsive to hormonal treatment in that blocking or removing testosterone from the patient will slow the growth of the cancer; response can't be predicted with certainty, but hormonal blockade can produce dramatic improvement in the size of the cancer, and slow the progression of the disease. But, talk to your father and see if he wishes to pursue this situation in regard to diagnosis and treatment, he may have indicated to the physicians that if it ain't broke, don't fix it approach was his choice. If so, then follow-up visits to see if there was progression of problems from the cancer would have been recommended. This is an example of where the art of the practice of medicine can be as important as the science of medicine. If your father were seen by a fourth-year medical student, probably all available tests and procedures would have been strongly considered. But everything depends on what is appropriate in each patient. Sometimes a patient just does not want to go through all that if they are not having significant problems. Hopefully, this information will be of assistance to you.

Q: My father's PSA levels are 9. Could he have prostate cancer?


A: Yes, he could, but you need more information. First, get another PSA to confirm the first one. Second, have a physical examination of the prostate, preferably by a urologist. Many other things can cause an increased PSA. I have seen PSAs higher than this on many occasions in patients who do not have prostate cancer. More important than the absolute level of PSA is the RATE at which it rises from one specimen to the next. Rapid rises are worrisome. This is the reason it is a good idea to have an annual PSA, so that the rate of increase, if any, can be studied from year to year. Interpreting PSA results is a notoriously difficult topic because many patients with high PSAs do not have cancer and many with normal PSAs have cancer, a fact that has led one leading expert to abandon using PSA and instead relying on annual physical examination of the prostate by rectal palpation (feeling the prostate through the anus).

Q: Information on prostate cancer?
DOES A LOW PSA LEVEL (BELOW 4) MEAN THAT PROSTATE CANCER HAS PROBABLY NOT SPREAD FROM THE PROSTATE? The person in question had a psa level of 5 so made appointment for biopsy, on the day of biopsy it was revealed that his psa level had dropped to below 4 but he still went through with biopsy and results showed he had cancer

A: No. It's far more complex than a simple PSA score. I'm going to assume that you mean that you, or someone you know, has been diagnosed with prostate cancer, and their PSA is low. It's encouraging that the PSA is low, but another, more critical number in assessing aggressiveness and likely spread of the cancer is the Gleason score. It's a combination of the two Gleason grades that were most frequent in the biopsy, and is expressed like this: 3+4=7, 3+3=6, 4+3=7, etc. The first number is the Gleason grade seen most in the individual's biopsy. You can take PSA, Gleason, whether the cancer was palpable during the rectal exam, and some other factors and get a rough idea of how likely it is that the cancer has spread, and whether or not it is likely to be curable. There are a few different tools on the web to do this--all scientifically validated. See the guide to this at: http://www.ehow.com/how_5275952_estimate-prostate-cancer-cure-odds.html Best wishes.

Q: Could it be Prostate Cancer?
My father (aged 52) has recently checked his PSA and it was 15ng/mL when it should be (at the most) 4ng/L. He did an ecography and it was all normal. What are the chances of him having prostate cancer considering the imagery shows no visible tumor? [by the way, last year he had the very same problem and the doctor diagnosed it as prostatitis. he kept checking his values and they went back to normal. Three weeks ago he had an undiagnosed infection and it is only now that his PSA values have boosted again.]

A: the PSA means nothing as far as cancer goes. Get that infection taken care of and teach him how to milk the prostate. gross but pleasurable, it helps A LOT you can chill...but educate yourself: MILK (not milking, above) CAUSES PROSTATE CANCER. so if your loved one is a fan of milk you might educate them and hopefully they will lay off the hormone laden food. http://www.milksucks.com/prostate.asp

Q: My dad is 52 yrs old and he was diagnosed with prostate cancer last thursday...?
I am looking at his results and it says he has a PSA at 9.7. Also his gleason score is 3+3=6/10. What does that mean? I am very worried about my dad. Any experiences to share?

A: 3+3 is about as good as it gets with a Gleason score. Most pathologists these days would not consider anything under 6 to even be cancer. And a PSA of 9.7 isn't that terrible either. What you hate to see is Gleason 9 or 10 and PSA over 20. Then you're in deep trouble. If you also know his clinical stage, which would be something like T2b, T2c, etc. then you can use online calculators at Memorial Sloan Kettering cancer center and other sites to estimate his chances of a cure with prostatectomy or radiation. For the MSK calculator you will also need to know how many cores from the biopsy were positive for cancer. See "How to Estimate Your Prostate Cancer Cure Odds" at http://www.ehow.com/how_5275952_estimate-prostate-cancer-cure-odds.html for more on these tools. These days, a lot men get diagnosed with prostate-confined disease, and the cure rate (yes, CURE rate) in such cases is nearly 100%. Getting prostate cancer is fairly common for men. The lifetime chance is about 1 in 6. However, 97% of all men die of something else besides prostate cancer. Even if you get diagnosed with it, your chance of dying from it is only about 1 in 8 overall--and if you catch and treat it early, as is likely to be the case with your dad, it can be just a bump in the road of life. Many, many thousands of men have been diagnosed, cured, and gone on to live their lives in this age of PSA testing. Don't be overly anxious. Your dad is on a path trodden by many, many others before him, who have done just fine. Best wishes.

Q: anyone first with prostate cancer and then after 3 years gets probable prostate or bladder cancer?
normal PSA but they still dont know if its from prostate bladder or urether.. help the cancer is being considered primary cancer not secondary: not a metastasis

A: if this person had prostate cancer three years ago and was treated and now the doctors are suspecting it came back and is now in the bladder or urethera this is very common, it is known as metastasis (meaning the cancer has spread to this area) this is why people who have gone through cancer and had therapy must be rechecked on aregular basis. You cannot be diagnosed as cancer free until you have not had any forms of cancer for 7 years. from the time of no cancer being detected after treatment until the 7th year you are considered in remission meaning body has suppressed itself from developing more cancer. Remember cancer today is nolonger a death sentence as it was once known to be. Cancer is when a normal cell during multiplication and duplication process goes freaky and continues to multiply and duplicate in a rapid fashion,(basicly "Cells Gone Wild").

Q: Questions about prostate cancer?
As my father was diagnosed with PC (75 yo, gleason 8, psa 11, stage T2b)I wanted to help him as he doesn't have any access to the Internet. After 2 months of searching I can now say that I'm quite good informed about the disease, the treatments etc. But I still have some critical questions: what is the turning point, after which this "mild" form of cancer turns into an agressive one and kills the patient? Does it happen after it escapes from the gland and causes metastases? Does it always escape from the capsule and treatment(any treatment) tries to keep it there as long as possible? I would very much appreciate if someone could answer these questions.

A: Prostate cancer is one of the most "curable" forms of cancer. many men live for years with it. overall there is a disease free survival rate of 70-85% for 5 years and a 45-75% for 10 years. most men diagnosed with prostate cancer are over age 65 and have other health issues. many men will die WITH prostate cancer but not BECAUSE of prostate cancer. the gleason score correlates closely with the prognosis. a gleason score over 8 and staging of T3-T4 is considered advanced stage disease. a gleason score of 8-10 is a moderately invasive cancer and more prone to metastisize. it is also usually faster growing than lower gleason score tumors. but the T2b means that the cancer is contained within the prostate and has not spread-and hopefully with treatment it won't. prostate cancer does not always escape from the capsule or metastisize. it does not suddenly turn aggressive and "kill" the patient. The treatments are designed to kill the cancer cells. (except surgical removal of the prostate) It's not about trying to keep the cancer encapsulated but getting rid of it. cancer cells are mutations and as such any damage to them from treatments will disable them from reproducing. the healthy cells are effected by the treatments as well but because they are normal cells they can repair themselves and replicate. as the cancer cells die off, the healthy cells reproduce and take their place. usually after treatments, the persons psa will go way down. i don't know what type of treatment your father is having but i do know that they are all very effective. there have been a lot of studies on prostate cancer and it is one of the cancers that is understood better than some others. if the cancer metastisizes then it becomes more serious but as of now, your father does not have any mets-so that is a good thing. i am a radiation therapist and about half my patients are being treated for prostate cancer with very good results. and by the way they all do not lose their manly manhood! hope this info helps. good-luck to you and your father.

Q: Anyone diagnosed with prostate cancer?
What was your PSA level? What treatment options have you chosen? Have you heard of Essiac tea?

A: My father was diagnosed with prostate cancer a few years ago. He had his prostate removed. A lot of other stuff happened, too, but I wasn't in the right mind to pay attention. The best thing to do is to go to Vanderbilt Hospital in Tennessee. It's the best hospital for that...Go to Dr. Joseph Smith, Jr. Anyway, he's cancer free, and recently has his PSA tested again...it's 0.02.

Q: I have prostate cancer year and half ego ..?
is a normal that the PSA increase every month from the past 6 month to the quantity of .06 average..? tks

A: My father has a psa level even after a prostectomy. He says there shouldn't be a level after that. They've been talking to him about chemo or radiation. He doesn't sound interested. (my grandfather died from prostate cancer)

Q: is it possible to have a PSA of 255? Urgent, please help.?
what does a PSA of 225 imply, is it possible that lab mistype the decimal point, so it is actually a 2.55 of 25.5. A 255 does not mean prostate cancer right! Because the doctor really cannot feel enlargement of the prostate gland or tumor. What is the scale used for PSA? What is the scale used for Free PSA. Thanks.

A: AS a physician who has ordered hundreds of PSA tests, I urge you to see your doctor soon. This is unlikely a lab error, when a lab gets a value that high it is rechecked before reported. (at least it damn well better be) There are really only 2 things that can cause a value that high: cancer of the prostate or an infection of the prostate. Most cancers of the prostate are not felt by the examining finger, they are deeper in the prostate gland. The scale for PSA varies slightly lab to lab and the PSA generally increases with age. However .5 to 3.5 ng/dl is considered normal all the way up to 9.5 for some one in their 80's. So as you can see the value you stated is way off the scale of normal. Call your doc, you have issues to discuss. Good luck Doc