High PSA & Prostatitis | Ask a Prostate Expert, Mark Scholz, MD
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- เผยแพร่เมื่อ 7 ก.ย. 2020
- Mark Scholz, MD, explains how prostatitis can complicate a prostate cancer diagnosis and how new PSMA-PET scans may help clarify these situations (pending FDA approval).
0:05 Do you have any stories from your practice of prostate cancer patients who experienced prostatitis?
3:37 What is Proscar used for? How can it complicate a diagnosis?
4:54 How effective is the PSMA-PET scan at diagnosing prostate cancer?
6:28 Is 3T MRI as effective as PSMA-PET scans for detecting abnormal lymph nodes?
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To learn more about prostate cancer visit www.pcri.org
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#ProstateCancer #Prostate #MarkScholzMD
I'm 70, my high PSA bounced from 5's to 8's to 5's to 8's....then suddenly to a PSA of 25 ! not only that, scan measured my prostate at 250cc..a huge one, and DRE showed it was lumpy, MRI scan revealed suspicious #4 and #5 hard lumps. I have a strong family history of prostate cancer 3 uncles dying of it. I was convinced as were all my 3 docs, cancer was present....but...a targeted MRI/ultra sound fusion biopsy proved the lumps, as well as all 12 needle cores...totally non-malignant...no cancer present.
Your experience parallels mine, I'm 73, PSA going up to nearly 20 over about 20 years, Got on Proscar, PSA going down each visit (6 months) to near 5 now. But Proscar has lower libido and erections weak (Blue pill helps). But I don't have issues urinating, a big plus. I always remind myself, doctors "practice" medicine.
Yes
Bill I am very happy for you. How are you doing today? Im 65 with a PSA of 10 which has been rising. I have terrible urinary problems were I pee 20 times a day. Did you have any symptoms? Im super fearful about tomorrow.
Thank you for explaining the pet scan test.
Great info - thank you
Very useful information, thank you!
Tomorrow is my initial visit to the Urologist. I am suffering from what I believe to be BPH. I also have a PSA reading of 10.1 currently. so this video has given me some reassurance it is not always cancer with a high PSA.
how did it go?
There are more than 20 different reasons for a high PSA and cancer is only one of them. If you have a high PSA ask for an MRI prostate exam DO NOT do a biopsy it is invasive and much less accurate than an MRI. The doctors will try and talk you into a biopsy and that’s because that’s how they make their money. Do not be fooled!
@@docbrady6397 Read "Invasion of the Prostate Snatchers" . Keep informed, get second and third opinions. Maybe you just have a large prostate, ask about that. And even if they find cancer, it may be slow growth kind, so don't be quick to have them "take it out"...side effects not good. Most men over 70 or 80 will have some prostate cancer, but no die from it.
Do not let them do a biopsy on you opt for the three T MRI prostate exam instead. Noninvasive much more accurate.
@@scubarojo Husband here. I read the prostate snatcher book, and I also highly recommend it to all men and others interested.
I'm 39, Dr thank you for sharing this information. My psa level was a 11.5 back in September, my primary had me take Dutasteride for 1 week and then I saw an urologist that told me to get off the Dutasteride right away. Weeks later I couldn't take it no more cause my anxiety and I went to the er and they did a ct scan and another psa and came back 5.4 and another few weeks or so my primary did another psa test and it was 6.9. My current urologist checked over my CT scan and did Dre and has ruled out that I have inflammation. This interview made me feel so much more assuring thank you for sharing again.
Sería bien si se traduce simultáneamente .
I am suffering from prostities last 4 years last 8 month I continues taking antibiotics 100mg and alfablockers but no changes
Anybody here can advise me It is very helpful
Very tuffest times i am going through
Thanks in advance
I am age of 41
My PSA came in at 96.5 recently. There are many factors that have to be considered before you make out your will and assume it's prostate cancer (or even worse metastasized prostate cancer). If you've had BPH or an infection those numbers can be significantly inflated. Stay on top of this number and trust your doctors. Push them for a biopsy if you aren't feeling 'right' down below. That's your best course of action.
I've heard the biopsy is very painful. Is that true?
Hmm, thanks for another great video. My PSA has started to rise a few months after stopping ADT. Now back on ADT and added Zytiga. Scans didn't show anything. I keep wondering if there is something else that could be causing the PSA to go high. PSA is responding to ADT so grateful for that. Wanted a PSMA scan but it was not approved by insurance. Maybe next time.
PSMA found my 0.13 ... 10 year post op cancer. I am in Canada, so it’s free. I know it financially hurts, but in my experience PSMA works where the others do not for small tumours.
@@plcamp1 Thanks for the input. I've actually stopped ADT and Zytiga for now. Letting the PSA rise so I can get a scan with something to find.
I had 5 uti’s over a 6-7 week period. My urologist wanted to cut but to me it felt like it really was my prostate giving harborage for the bug. I made an appointment with an infectious disease specialist. I explained to her what I thought and we picked an antibiotic I knew would partition fairly equally between water and oil. I did a 3 week treatment with phosphomycin 8 months ago and I am still free of uti’s. I no longer feel like I have a walnut in my crotch.
By the way I’m 80
Hello
Can you please ask a question
I had a rectal exam which showed swelling in July 2022
A MRI with showed aggressive legion on the left and into the neurovascular bundle with a PI-RADS of 5 and the PSA was 25
My specialist said it was fine to wait for 3 months until I got back from leave. It is August and I just got
I got another PSA test done as I thought something didn't sound right.
Now my PSA is 130
But I feel good except for slowed urination And i am just recovering from siatica which started in late june is there still hope.
Thankyou
Good seminal flow
I'm only 37 and suffering from all the symptoms except no blood. Been going on for 2years getting to the point I can't take it no more especially at night. Finally made the phone call to doc's this morning, hopefully nothing to serious 🤞
I hope it went well for you.
Good luck friend. We're all in this together.
I had a PSA test with a result of 10.45. The year before it was 1.85 I had to wait four weeks to see a urologist who did a digital exam and felt what he called a "small bump" He wanted a 12 core biopsy performed and I had to wait four more weeks. Just had my biopsy and it came back benign . He now wants to wait three months and do another PSA test. I spent two months totally scared to death waiting to get a biopsy just to find out all cores had no cancer. No to figure out next step.
What is ur age
Quinton - I'm very happy for you. How are you doing now? I got a PSA of 10. My DRE was OK. I am getting an MRI tomorrow. I pee like 20 times a day and have a burning sensation there. Did you have any urinary symptoms? I'm very worried about tomorrow.
@@luketimber4679 How are you doing right now? What was the diagnosis, finally, for you? I am in the same situation with similar symptoms. My PSA was 12, and now suddenly shot up to 20.
@@hn5460 Had a radical prostatectomy in April. Had Gleason 7 -- unfavorable. Half prostate full of cancer. Had a PET scan beforehand --indicating it had not spread. The pathology report was OK. I am PSA undectable. now.
@@luketimber4679 I am happy for you with the PSA level undetectable at this moment, 4 months after the RP.
How were the side effects of the RP, especially the incontinence? Are you happy with the results so far?
55 and diagnoses with BPH in 2013. Now 55, my PSA is at 3.85 and GP says I need to see a urologist.
Hi. I just had a prostate multiparametric MRI due to PSA of 4.7 ug/L, i am still waiting for the result of the MP MRI. I just want to ask, what if on the MP MRI result no cancer or malignancy is seen on my prostate, do i still need to have a PSME PET scan? Is PSME PET SCAN only needs to be done if there is a cancer seen on prostate? Thank you very much.
Hello,
Feel free to contact our free helpline. We have a patient advocate who will call you and may be able to provide you with some information: pcri.org/helpline
will taking B 17 cause the psa to go higher?
Don't know if my PSA was a mistake or my prostate symptoms are from something else, like a weak pelvic floor? But i have had symptoms such as urgency to urinate, frequent urination, growing pain, and even difficulty starting stream and emptying my bladder. But, my last PSA was only 0.2 (wonder if this is a mistake? that seems unusually low even for a healthy prostate.) When I had my first prostate exam when these symptoms started (age 45), I was told my prostate was slightly enlarged but normal for my age. But I sometimes have extreme symptoms.
Sounds like BPH, enlarged Prostate, even though your is only slightly enlarged, it may be enlarged enough for you to have all those symptoms.
Thank you so much.
I want to ask about the effectiveness of NanoKnife for advanced prostate cancer with low volume of bone mets.
Hello Mostafa, our prostate cancer helpline may be able to help with your question. Please feel free to contact us here: pcri.org/helpline
Where is a reliable center to get a PSMA-PET in AZ/SoCal?
Hello Charles, our prostate cancer helpline may be able to help with your question. Please feel free to contact us here: pcri.org/helpline
@@ThePCRI
Hi. I just had a prostate multiparametric MRI due to PSA of 4.7 ug/L, i am still waiting for the result of the MP MRI. I just want to ask, what if on the MP MRI result no cancer or malignancy is seen on my prostate, do i still need to have a PSME PET scan? Is PSME PET SCAN only needs to be done if there is a cancer seen on prostate? Thank you very much.
At 73 I suddenly had a jump from PSA 1.0 to 28.0. DRE and biopsies showed normal prostate. Was a spike due prostatitis. Antibiotics brought it down to 2.0.
My dad is getting a 12-core biopsy. Sedation or no sedation? I am still confused if he really needs it. How long is the recovery from biopsy? 2 months? How long is the bleeding period? He does have issues with urinating frequently. He is prescribed Flomax and Tamsulosin I believe. I am unsure if he has cancer. He eats healthy. He doesn't eat meat. He probably has prostatitis.
Thanks. I'm a couple decades younger but mine went to 96.5. Spent a week in the hospital for the UTI. 6 weeks later after antibiotics it's just below 4. Just offering some hope out there.
Is it suggested to take medicine to bring down your PSA ? I believe I would rather get an MRI to rule out cancer first. I’m 58 and my PSI has slowly risen over the years. The past 3 years it went from 4.1 to 4.0 and this year 6.0 but then I took another PSA test a few weeks later and it was back down to 4.8. My rectal exam went well but he still wants me to get a 3T MRI just to be safe. I will be scheduling that in the next few weeks. I have no family history but after doing research I found it doesn’t matter if you have a family history or not ,you can still get prostate cancer. I want to play it safe
Sir,My age is 48
My psa before is 12.1
then i take medicine
After 2 weeks my psa is 6.21
Any advice..thanks
Which medicen u used
Which medicine u used plz reply
You are a liar !
PSA can increase and des crease !
Yes
I'm 71 years old. My first PSA test result after RP is 0.014 and the 2nd PSA test result after another 2 months is 0.037. what does this means
What about a pet scan test??
Seems to me that a PSMA PET scan ought to be done before a biopsy? Or am I missing something? That would save a lot of needless biopsies along with the associated anxiety and discomfort.
It could be in the future, but right now it has only been studied and FDA-approved for people who at risk of having metastatic prostate cancer, which means having a pathology result with a Gleason 3+4=7 or higher. 3T multiparametric MRI is oftentimes used before a biopsy in prostate cancer. It is not universal, but some people are able to get one upon request. It is important, though, to make sure the radiologist and the radiology team have a lot of experience with these kind of MRIs because there is high inter-reader variability.
If you have any questions, feel free to contact our helpline here: pcri.org/helpline.
@@ThePCRI well I hope the day comes when PSMA PET is available for all, and affordable. I had a 3T MP-MRI a month ago and fusion biopsy scheduled tomorrow. So I am thankful for that bit of technology, at least. 🙂
PSA 800 what effect on body
Sir my father has PSA of 155 can it be lowered or its a sign of cancer
How is your dad? My husband has his first urologist appointment today and I have been up all night crying, stressing and praying for strength to handle whatever outcome may be.
What was your husband's PSA and what are the results now...what doctors said???
@@factfactory3663 I'm not exactly sure the numbers but at his urology appointment, they definitely felt hardening on one side of his prostate so now he has an MRI on Saturday. I'm not sure what to expect! It's a stressful road.
I'm worried about my father may Allah bless every patient with health.
@@factfactory3663 what did they say about your father?
is having 52 psa dangerous?
Hi, I'm 66 years old, male. My PSA went up from 4.2 to 5.0 in 6 months. Is this a concern? I have no symptoms, woke up only once to go to the bathroom in the middle of the night. Any advices, thanks very much.
Hello,
Prior to treatment, there is not much that can be inferred by the rate at which PSA rises; however, most doctors would consider a PSA above 4 to be worthy of further investigation to ensure that the rise is not due to a type of prostate cancer that is able to metastasize. (A PSA of 4 is a generic cutoff that assumes the patient has an average-sized prostate.) There are a number of options--each with its own efficacy and risks--that can be used alone or in combination depending on what is available near your location (unless you are willing and able to travel) and how thorough you and your doctor wish to be considering the risk of there being dangerous prostate cancer against the ease or invasiveness of each method. Some of those methods include: retaking the PSA to see if it goes back down, using an ultrasound to determine the size of the prostate and calculate the PSA density (that is, whether a higher than normal PSA is expected due to enlargement of the gland), assays like 4K which are designed to assess the risk of having dangerous prostate cancer, multiparametric MRI which can see the whole gland and determine if there are suspicious lesions that should be targeted by a biopsy, or a 12-core blind biopsy to see if random sampling of the prostate gland detects the presence of a dangerous cancer.
We have videos on all these methods, so if you would like to know more, let me know. You are welcome to contact our free helpline at pcri.org/helpline.
I had similar issues.
I was talked into a doing a biopsy after a normal DRE with a PSA of 6.2 at age 70. My biopsy was negative for cancer after doing it. My libido dropped following the biopsy, passing blood and tiny tissue in my urine for 3 weeks. The biopsy is VERY INVASIVE. Take my advice, DO NOT DO A BIOPSY if your DRE is normal at your age. I regret doing it.
@@anthonynattoo1935 They made me have a biopsy when I was 42 because I had one UTI and my prostate level was slightly higher. As you say horrible experience I had to take a week off work. Came back negative I’m now 60 and I had a very slight increase in PSA level 5.5 to 6.9 Had a couple of infections during a month. After antibiotics it went back down from 6.9 to 5.3. I’m awaiting the results of another PSA scan and urine test.
My doctor is pushing for a biopsy but I've heard they're very painful. My psa is 4.0 but Anyone MRI shows a small spot. Anyone have any thoughts on this? I'd appreciate any I put you have.
Painful is not the major concern. There is a 5% chance you will get permanent ED as a result of the biopsy, plus infection risk.
@@theSilvioRoesler I asked my doctor about the risk of infection from the needle going through your colon into the prostate gland and also the risk of spreading any cancerous cells around by withdrawing the needle. My primary doctor didn't have an answer for that and my specialist just blew off the question. Everything about a biopsy concerns me.
You definitely need a biopsy due to the showing on MRI.
If chronic prostatitis is cancer? My doctor gave me an ultrasound, urine, and digital rectal exam and told me I had chronic prostatitis.
I am 64 from Pakistan. I have enlarged prostate. It is 40 grams. I do have problems emptying my bladder with weak stream over the years but most recently more severe. My PSA in June 2021 was 1.17. On 4 March 2022 it went up to 4.41. I consulted a Urologist who did DRE and felt nothing suspicious. He advised septron and a repeat PSA test after 6 weeks. After taking the first dose of septron I had severe tingling as a result I discontinued septron immediately and instead used cranberry sachet and apple cider. I also started taking flomax for the last 6 weeks. I repeated my PSA test after six weeks and it came out to be 1.61. I went to a second lab and repeated the test next day. It came out to be 1.81. Then the same day I repeated the test In a third lab and it came out to be 1.69. Sir What do you? advise.
It is very clear that you have nothing to worry about. Your PSA levels are normal and typical for your age.
My PSA went from 1 to 5 in a year at age 48. I have had a history of prostatitis but this is concerning to me.
Hope you r doing well, how is your psa now
My age is 57 and my psa is 33 what i do
Hello, if you have questions, please do not hesitate to submit them here: pcri.org/helpline
alok shukla. See a urologist
@@ThePCRIis a prostate biopsy painful?
She is beautiful
What are the odds of a 68 year old man having Prostate cancer of their psa levels went from 5.3 to 14.9 in 2 months? That's is my father's case at the moment. So nervous he has an aggressive cancer
What is the diagnosis for your father? Did they conclude that it is an aggressive cancer?
@@hn5460 he just got his results, they found cancer. He has a Gleason score of 7. He's choosing to get it removed. So they'll remove it and he'll get biopsies in the future to make sure the cancer doesn't come back.
The PSA is overrated and totally worthless!!! My PSA has been elevated for the last 20 years... Gotta love BPH!!! Stop worrying and start living!!!
What was your PSA level?
@@kamrunrimu4277 My PSA has varied from a 4.03 to 5.69 with a baseline of 5.03
@@markracer3281 what was ur symptoms
Psa test is 98 % accurate.
Maybe for you but not me...