Suggest Ways To Rule Out Prostate Cancer

Posted on Tue, 22 Aug 2017

Question: With hx.Moderate aggressive cancer of prostate-2008/ all three lobes involved. P.S.A. done annually. Was @ 0.0-2009-2015: 2016 P.S.A. @ 0.02. Today, P.S.A. @ 0.7. What's potential differential diagnosis know total, impotence, incontinence, pain, .

Answered by Dr. Chobufo Ditah (1 hour later)

Brief Answer:
Did you undergo surgery for prostate cancer?

Detailed Answer:
Hi and thanks so much for this query.

I have a few questions for you.

1. Did you have prostate surgery? Your PSA are well within normal limits and really do not raise further concerns about possible cancer related to the prostate.

2. How is your urine? Any yellowish coloration of your eyes? Did you smoke? Any heavy alcohol consumption? Weight loss and abdominal pain raises the question of a possible cancer of the pancreas. I will suggest that your doctor evaluates for this. I recommend an abdominal CT to look at the structures in the abdomen.

I hope this guides and helps. I wish you well. Feel free to follow up with me as you please.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Chobufo Ditah (31 minutes later)

I did have a Radical Prostectomy in 2008 and maintained zero psa till last year and this year is 0.7 spa. How can that be if my prostate was removed.Radical Prostectomy 2008/ urgency incontinence( bowel and bladder).Anterior Suprapubic Surgical approach/ Path: 3 Segments involved, moderately aggressive cancer, nerve damage, impotence, chronic groin and low back pain( brace, Nor o 10/325mg 1 q4 hrs PRN pain, valium 20mg-1 q;8prn spasms, lidocaine 5% Transdermal patch for back & Suprapubic placement- 1patch q 24 hrs. Stanford University Medical School-Genetics review confirmed forms of Cancer present a d DNA EVALUATION Positive Genetic Predisposition for Bladder Cancer. PSA-2008-2015 yearly and. UA Cytology. 2015- PSA ^ from 0.0 to 0.02. Now PSA ^ 0.7. How is this possible without a Prostate? What might cause increase@my 10year mark???

Answered by Dr. Chobufo Ditah (13 hours later)

Brief Answer:
I will suggest that you do a PET scan!

Detailed Answer:
Hi and thanks for this follow-up information.

I have reviewed it fully.

Though PSA is not entirely from the prostate, a continued rising trend is concerning. I will suggest that you get a PET scan to look for any possible remnants of prostate tissue after the surgery that might explain this.

I will recommend you bring this up to your urologist too. Please keep me updated on the response.

I wish you well and hope to hear from you soon!

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Above answer was peer-reviewed by : Dr. Arnab Banerjee