Nelson Vergel
Founder, ExcelMale.com
PSA
These questions and answers are in addition to the frequently asked questions on this topic. They are archived questions and answers which were asked and answered on this website.
Please read the FAQs on this topic before going through these Q&As.
TAMULOSIN AND PSA: Will tamsulosin decrease my PSA level?
Tamsulosin is a drug frequently prescribed for men who have severe urinary symptoms from benign enlargement of their prostate. It does not shrink the prostate and does not lower the PSA level. Two other drugs that also are prescribed for treating benign enlargement are Avodart and Proscar. These drugs usually do shrink the prostate and lower the PSA level. Two concerns that I have about using these drugs are: 1) they may mask prostate cancer and create a false sense of security about the PSA level being lower than it really is, and 2) patients taking these drugs for several years have a significantly higher incidence of being diagnosed with the highest Gleason grades (most aggressive) of prostate cancer (Gleason grades 8, 9, or 10).
PSA ABOVE THE MEDIAN: I am 68 years old. My PSA reading was 6.8 and it has come down to 6.3. Is this a good sign?
The median PSA level for a man in his 60s is 1.3 and for a man in his 70s is 1.7. Men whose PSA is higher than the median for their age group are at an increased risk for having prostate cancer. Thus, your PSA of 6.3 is concerning. The cause for the high PSA could be prostate cancer, benign enlargement of the prostate, inflammation in the prostate, or any combination of these conditions. The fact that the PSA decreased suggests that inflammation is at least part of the cause. Nevertheless, you should be evaluated by a urologist. I am now using the Prostate Health Index (phi) blood test for this purpose, as it provides more information than the standard total PSA and free PSA tests. See the Spring 2014 Quest for more information on the phi test.
CLOMID, TESTOSTERONE, AND PSA LEVELS: I am a 52-year-old white man. Three years ago I had a low testosterone and a PSA of 0.9. I started taking Clomid for infertility, and as my testosterone level increased, my PSA increased to 7.5. A biopsy revealed cancer in 2 of 12 samples (5% and 15%). After stopping Clomid, my testosterone level decreased, and my PSA fell to 1.15. What would you advise?
Two important missing pieces of information are whether you are healthy and the Gleason grade of your tumor. I would advise you to have the slides reviewed by another pathologist. If the diagnosis of prostate cancer is confirmed and you are healthy, because of your young age, in my opinion a nerve-sparing prostatectomy would be preferred over surveillance or radiation therapy. Prostate cancers arising in men with low testosterone sometimes are more aggressive.
More here
These questions and answers are in addition to the frequently asked questions on this topic. They are archived questions and answers which were asked and answered on this website.
Please read the FAQs on this topic before going through these Q&As.
TAMULOSIN AND PSA: Will tamsulosin decrease my PSA level?
Tamsulosin is a drug frequently prescribed for men who have severe urinary symptoms from benign enlargement of their prostate. It does not shrink the prostate and does not lower the PSA level. Two other drugs that also are prescribed for treating benign enlargement are Avodart and Proscar. These drugs usually do shrink the prostate and lower the PSA level. Two concerns that I have about using these drugs are: 1) they may mask prostate cancer and create a false sense of security about the PSA level being lower than it really is, and 2) patients taking these drugs for several years have a significantly higher incidence of being diagnosed with the highest Gleason grades (most aggressive) of prostate cancer (Gleason grades 8, 9, or 10).
PSA ABOVE THE MEDIAN: I am 68 years old. My PSA reading was 6.8 and it has come down to 6.3. Is this a good sign?
The median PSA level for a man in his 60s is 1.3 and for a man in his 70s is 1.7. Men whose PSA is higher than the median for their age group are at an increased risk for having prostate cancer. Thus, your PSA of 6.3 is concerning. The cause for the high PSA could be prostate cancer, benign enlargement of the prostate, inflammation in the prostate, or any combination of these conditions. The fact that the PSA decreased suggests that inflammation is at least part of the cause. Nevertheless, you should be evaluated by a urologist. I am now using the Prostate Health Index (phi) blood test for this purpose, as it provides more information than the standard total PSA and free PSA tests. See the Spring 2014 Quest for more information on the phi test.
CLOMID, TESTOSTERONE, AND PSA LEVELS: I am a 52-year-old white man. Three years ago I had a low testosterone and a PSA of 0.9. I started taking Clomid for infertility, and as my testosterone level increased, my PSA increased to 7.5. A biopsy revealed cancer in 2 of 12 samples (5% and 15%). After stopping Clomid, my testosterone level decreased, and my PSA fell to 1.15. What would you advise?
Two important missing pieces of information are whether you are healthy and the Gleason grade of your tumor. I would advise you to have the slides reviewed by another pathologist. If the diagnosis of prostate cancer is confirmed and you are healthy, because of your young age, in my opinion a nerve-sparing prostatectomy would be preferred over surveillance or radiation therapy. Prostate cancers arising in men with low testosterone sometimes are more aggressive.
More here
