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Are Regular Check-ups Advisable When With A Family History Of Prostate Cancer?
Question: I have a question. My psa in 2013 was 4.1 in 2014 3.7, about 2 wks ago 4.4. My doctor suggested I go see a urulogist. I had a appointment today. I had rectum examine today. He said it was nice and small and very smooth. I do have a family history. My uncle many years ago die from prostate cancer. My father who had prostate cancer had radaration 8yrs. ago.He's doing fine he's 86 yrs. old. My cousin who at 55 just came up with prostate cancer. He has it advance and it's in the bone. Never went to the doctor.My health is good allittle touch of high blood pressure. I am 60 yrs old. Should I go and do the the biopsy. I have a call into my doctor, but of course he's on vacation. I have a appointment in a week, am doing the right thing.
Brief Answer:
Please follow step wise approach for prostate cancer screening
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. A change in PSA level from 4.1 in 2013 to 4.1 in 2014 and presently at 4.4 is not alarming for prostate cancer. PSA might rise slightly due to benign conditions including infections. However regular follow up screening is required.
2. Discussing further on elevated PSA levels, 1 in 4 people with high PSA levels proceed to have a cancer. Your PSA velocity (rate of change in velocity) is not indicative of a cancer.
3. PSA circulates in the blood in two forms either free or bound to certain blood proteins. If you have a high PSA level but a low percentage of free PSA, then close follow up and ruling out cancer becomes important. This test is used for men with a PSA level in the borderline range between 4 and 10. Research shows that if more than a quarter (25%) of the total PSA is free, there is less chance of having prostate cancer. I recommend you also get a free PSA test done to know the risk of cancer if any.
4. Once free PSA is done and due to the invasive nature of a prostate biopsy, less invasive methods might first be used to study your prostate gland. You can go for a trans rectal ultrasound scan of prostate first.
5. Biopsy is done if there is any suspicious lesion on trans rectal ultrasound scan. Keeping an appointment with the urologist is important and I hope they take note of a strong family history of prostate cancer and guide you with the required investigations. If required, this will be done using ultrasound guidance. Should you have any lower back pain then doing an MRI scan of the region is essential.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please follow step wise approach for prostate cancer screening
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. A change in PSA level from 4.1 in 2013 to 4.1 in 2014 and presently at 4.4 is not alarming for prostate cancer. PSA might rise slightly due to benign conditions including infections. However regular follow up screening is required.
2. Discussing further on elevated PSA levels, 1 in 4 people with high PSA levels proceed to have a cancer. Your PSA velocity (rate of change in velocity) is not indicative of a cancer.
3. PSA circulates in the blood in two forms either free or bound to certain blood proteins. If you have a high PSA level but a low percentage of free PSA, then close follow up and ruling out cancer becomes important. This test is used for men with a PSA level in the borderline range between 4 and 10. Research shows that if more than a quarter (25%) of the total PSA is free, there is less chance of having prostate cancer. I recommend you also get a free PSA test done to know the risk of cancer if any.
4. Once free PSA is done and due to the invasive nature of a prostate biopsy, less invasive methods might first be used to study your prostate gland. You can go for a trans rectal ultrasound scan of prostate first.
5. Biopsy is done if there is any suspicious lesion on trans rectal ultrasound scan. Keeping an appointment with the urologist is important and I hope they take note of a strong family history of prostate cancer and guide you with the required investigations. If required, this will be done using ultrasound guidance. Should you have any lower back pain then doing an MRI scan of the region is essential.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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