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General Health & Fitness
Nutrition and Supplements
Carnitine for PSA
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<blockquote data-quote="sbstrum_MD" data-source="post: 97275" data-attributes="member: 17682"><p>I am very familiar with TRT (testosterone replacement therapy) and the potential pitfalls. I call TRT a "stress test" for prostate cancer. The fact that you have had a serial &#8593; in PSA is of course highly suspicious for you having occult prostate cancer (PC). Key caveats re this interpretation include:</p><p>1. Using the same PSA assay for each test. </p><p>2. Not obtaining a PSA if any ejaculation within 48 hrs prior to the test. </p><p>3. No DRE prior to PSA testing. </p><p></p><p>If a patient under my care had this history I would (a) want to know if any family history of PC, breast cancer or colorectal cancer (CRC) since these are genetically linked (b) would certainly want to know what a DRE (digital rectal exam) showed, (c) would consider a urine test for PCA3 and (d) might consider a multi-parametric MRI (mp-MRI) done at a creditable imaging center if biopsies were being considered. I would not let this ongoing rise continue re PSA without major intervention. This is prostate cancer until proven otherwise. And this may be a blessing since most patients I have seen diagnosed in this manner will have &#8595; in PSA once the TRT is dc'd. And in most we could not find PC on subsequent biopsies. So the TRT appears to make known occult PC. Of importance would be to know what your total and free testosterone were prior to any TRT.</p></blockquote><p></p>
[QUOTE="sbstrum_MD, post: 97275, member: 17682"] I am very familiar with TRT (testosterone replacement therapy) and the potential pitfalls. I call TRT a "stress test" for prostate cancer. The fact that you have had a serial ↑ in PSA is of course highly suspicious for you having occult prostate cancer (PC). Key caveats re this interpretation include: 1. Using the same PSA assay for each test. 2. Not obtaining a PSA if any ejaculation within 48 hrs prior to the test. 3. No DRE prior to PSA testing. If a patient under my care had this history I would (a) want to know if any family history of PC, breast cancer or colorectal cancer (CRC) since these are genetically linked (b) would certainly want to know what a DRE (digital rectal exam) showed, (c) would consider a urine test for PCA3 and (d) might consider a multi-parametric MRI (mp-MRI) done at a creditable imaging center if biopsies were being considered. I would not let this ongoing rise continue re PSA without major intervention. This is prostate cancer until proven otherwise. And this may be a blessing since most patients I have seen diagnosed in this manner will have ↓ in PSA once the TRT is dc'd. And in most we could not find PC on subsequent biopsies. So the TRT appears to make known occult PC. Of importance would be to know what your total and free testosterone were prior to any TRT. [/QUOTE]
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Carnitine for PSA
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