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Hellohello Are You Online Now?

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Posted on Tue, 3 Mar 2020
Question: hellohello are you online now?
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Follow up: Dr. Anders Mark Christensen (0 minute later)
hellohello are you online now?
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Follow up: Dr. Anders Mark Christensen (3 minutes later)
I thought you were online.

I want your opinion.

One doctor wants that I do an MIR to see if I need a biopsy. The other doctor says I should skip the MIR and do a biopsy directly. What should I do?
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Follow up: Dr. Anders Mark Christensen (0 minute later)
I thought you were online.

I want your opinion.

One doctor wants that I do an MIR to see if I need a biopsy. The other doctor says I should skip the MIR and do a biopsy directly. What should I do?
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Follow up: Dr. Anders Mark Christensen (9 minutes later)
The website said answer within minutes. I posted in the follow up my question 7 minutes ago. until now no answer. I thought you were online. This is my trial of this service. Is this a scam? Did I just lose $35?
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Follow up: Dr. Anders Mark Christensen (0 minute later)
The website said answer within minutes. I posted in the follow up my question 7 minutes ago. until now no answer. I thought you were online. This is my trial of this service. Is this a scam? Did I just lose $35?
doctor
Answered by Dr. Anders Mark Christensen (39 minutes later)
Brief Answer:
I need more information

Detailed Answer:
Hi Davegova,

Thank you for your question. I cannot find any details of the organ in question. What have you been told should be biopsied or scanned?

Looking forward to hearing from you.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Anders Mark Christensen (0 minute later)
Brief Answer:
I need more information

Detailed Answer:
Hi Davegova,

Thank you for your question. I cannot find any details of the organ in question. What have you been told should be biopsied or scanned?

Looking forward to hearing from you.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Anders Mark Christensen (28 minutes later)
Thank you doctor. I am sorry I am new to this. Thank you for your answer.

I am speaking of the prostate. My PSA has slowly climbed from 5 to 8 over the course of about two years. I also have pelvic pain, enlarged prostate, epidemitis in the right testis, that is not painful when I am not in crisis. When in crisis my right testis hurts, also my right back and a point in the pelvic region. Also I feel I need to pass bowels but when I go the toilet, I can do nothing. All those symptoms arrive at the same time when I have a crisis.

It is on and off. I can go a few days without a crisis then it comes for no apparent reason.

I talked to two different urologist. One said I should first do an MRI to see if it is necessary to do a biopsy. I have an appointment for MRI in XXXXXXX The other said I should skip the MRI and do directly the biopsy. I have an appoint next week.

I am uncomfortable with a biopsy after all I read about it (that was after he gave me the appointment). Also I read on the internet that my symptoms are more typical of a chronic prostatitis than a cancer, in my opinion. For cancer I find only symptoms related to urination, and though it is a little more difficult for me to urinate indeed (maybe do to the enlarged prostate), it doesn't cause me problem.

So this is my first question: the symptoms I describe (and that I attribute to a prostitatis) could be also caused by a cancer, that would make it worth it to make a biopsy? I could find no reference about that, they only speak about urination not about pelvic pain and constipation, but I don't know, that is why I need to ask a doctor.

Another fear I have of the biopsy is that my condition, which is for the moment occasional (I have a crisis of about 3 hours maybe every 10 days or so), would become permanent because if 12 sample extracted through a needle in my already sick prostate.

So this is my next question: could this possibly happen? In this case I better say with my present sickness that is at leat bearable with 3 hours crisis in about every 10 days.

So what do you think? Should I cancel the biopsy and wait to do the MRI in XXXXXXX or should I push through with the biopsy now?

Maybe treating me for chronic prostatitis first would also bring down the PSA. I read on the internet that this is so. Then why not try this first rather than do a potentially dangerous biopsy? My prostatitis is not bacterial, we have try long antibiotic sessions already, it doesn't change anything.

By the way? Should this question not be answered to a urologist? I thought I sent it directly to the urologist that was said to be online.

Thank you.
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Follow up: Dr. Anders Mark Christensen (0 minute later)
Thank you doctor. I am sorry I am new to this. Thank you for your answer.

I am speaking of the prostate. My PSA has slowly climbed from 5 to 8 over the course of about two years. I also have pelvic pain, enlarged prostate, epidemitis in the right testis, that is not painful when I am not in crisis. When in crisis my right testis hurts, also my right back and a point in the pelvic region. Also I feel I need to pass bowels but when I go the toilet, I can do nothing. All those symptoms arrive at the same time when I have a crisis.

It is on and off. I can go a few days without a crisis then it comes for no apparent reason.

I talked to two different urologist. One said I should first do an MRI to see if it is necessary to do a biopsy. I have an appointment for MRI in XXXXXXX The other said I should skip the MRI and do directly the biopsy. I have an appoint next week.

I am uncomfortable with a biopsy after all I read about it (that was after he gave me the appointment). Also I read on the internet that my symptoms are more typical of a chronic prostatitis than a cancer, in my opinion. For cancer I find only symptoms related to urination, and though it is a little more difficult for me to urinate indeed (maybe do to the enlarged prostate), it doesn't cause me problem.

So this is my first question: the symptoms I describe (and that I attribute to a prostitatis) could be also caused by a cancer, that would make it worth it to make a biopsy? I could find no reference about that, they only speak about urination not about pelvic pain and constipation, but I don't know, that is why I need to ask a doctor.

Another fear I have of the biopsy is that my condition, which is for the moment occasional (I have a crisis of about 3 hours maybe every 10 days or so), would become permanent because if 12 sample extracted through a needle in my already sick prostate.

So this is my next question: could this possibly happen? In this case I better say with my present sickness that is at leat bearable with 3 hours crisis in about every 10 days.

So what do you think? Should I cancel the biopsy and wait to do the MRI in XXXXXXX or should I push through with the biopsy now?

Maybe treating me for chronic prostatitis first would also bring down the PSA. I read on the internet that this is so. Then why not try this first rather than do a potentially dangerous biopsy? My prostatitis is not bacterial, we have try long antibiotic sessions already, it doesn't change anything.

By the way? Should this question not be answered to a urologist? I thought I sent it directly to the urologist that was said to be online.

Thank you.
doctor
Answered by Dr. Anders Mark Christensen (14 minutes later)
Brief Answer:
There are several possibilities

Detailed Answer:
Hi again XXXXXXX

Thank you for elaborating. Your question falls well within the field of general surgery and personally, I also have extensive experience with urology.

What you describe can be several conditions, e.g. benign prostate hyperplasia, chronic prostatitis or cancer.

Given your symptoms and clinical findings (PSA of 8, pain, enlarged prostate) I find chronic prostatitis most likely. However, it is not clear to me if you have been thoroughly examined? Typically, I would recommend urine cultures for bacteria, transrectal ultrasound, and only antibiotics (long course) if there are bacteria in your urine. What type of antibiotics have you tried and for how long?

Your PSA is not alarmlingly high, and it could easily be explained by chronic prostatitis. As you mention, doing biopsies also carries the risk of bacterial contamination and worsening of your symptoms.

In my opinion (and based on the information you have provided), you have chronic prostatitis where a transrectal ultrasound could help provide a diagnosis. Further to this, it would be meaningful to assess uroflow dynamics as some of your symptoms could simply be to prostate enlargement and/or overactive bladder syndrome, and these conditions can be treated.

I look forward to hearing from you again.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Anders Mark Christensen (0 minute later)
Brief Answer:
There are several possibilities

Detailed Answer:
Hi again XXXXXXX

Thank you for elaborating. Your question falls well within the field of general surgery and personally, I also have extensive experience with urology.

What you describe can be several conditions, e.g. benign prostate hyperplasia, chronic prostatitis or cancer.

Given your symptoms and clinical findings (PSA of 8, pain, enlarged prostate) I find chronic prostatitis most likely. However, it is not clear to me if you have been thoroughly examined? Typically, I would recommend urine cultures for bacteria, transrectal ultrasound, and only antibiotics (long course) if there are bacteria in your urine. What type of antibiotics have you tried and for how long?

Your PSA is not alarmlingly high, and it could easily be explained by chronic prostatitis. As you mention, doing biopsies also carries the risk of bacterial contamination and worsening of your symptoms.

In my opinion (and based on the information you have provided), you have chronic prostatitis where a transrectal ultrasound could help provide a diagnosis. Further to this, it would be meaningful to assess uroflow dynamics as some of your symptoms could simply be to prostate enlargement and/or overactive bladder syndrome, and these conditions can be treated.

I look forward to hearing from you again.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Anders Mark Christensen (3 hours later)
Thank you. Sorry I see only your answer now. I will have to think a little bit before my answer if any. Thank you again.
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Follow up: Dr. Anders Mark Christensen (0 minute later)
Thank you. Sorry I see only your answer now. I will have to think a little bit before my answer if any. Thank you again.
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Follow up: Dr. Anders Mark Christensen (19 minutes later)
I can't remember exactly what antibiotic I received but these were given to me by urologists specifically to try and heal my condition, so I guess they hopefully gave me the right ones. I took them for many weeks, to the point that fungus started to develop in my urine. Then we stopped and they concluded that my condition was not due to bacteria.

Urine culture have also been done and they came out negative.

My urologue programmed me for an euroflow test indeed at the end of this month.

I think that, given that the rate and speed of my PSA is not that bad, I will probably cancel the too-early programmed in my opinion biopsy and wait XXXXXXX for the MRI. MRI is supposed to give a better picture even than transrectal ultrasound, isn't it? And it can also be used to better direct the biopsy if it really comes to that.

I have a question that is not as yet very clear to me, in two parts:

1. The symptoms described as of prostatitis, but could cancer create similar symptoms as well?

2. Is the fact of having chronic prostatitis increasing the risk of cancer, or, on the contrary, could the prostatitis be created by the cancer itself, be the cause of it?

Thanks, looking forward to hear from you gain.
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Follow up: Dr. Anders Mark Christensen (0 minute later)
I can't remember exactly what antibiotic I received but these were given to me by urologists specifically to try and heal my condition, so I guess they hopefully gave me the right ones. I took them for many weeks, to the point that fungus started to develop in my urine. Then we stopped and they concluded that my condition was not due to bacteria.

Urine culture have also been done and they came out negative.

My urologue programmed me for an euroflow test indeed at the end of this month.

I think that, given that the rate and speed of my PSA is not that bad, I will probably cancel the too-early programmed in my opinion biopsy and wait XXXXXXX for the MRI. MRI is supposed to give a better picture even than transrectal ultrasound, isn't it? And it can also be used to better direct the biopsy if it really comes to that.

I have a question that is not as yet very clear to me, in two parts:

1. The symptoms described as of prostatitis, but could cancer create similar symptoms as well?

2. Is the fact of having chronic prostatitis increasing the risk of cancer, or, on the contrary, could the prostatitis be created by the cancer itself, be the cause of it?

Thanks, looking forward to hear from you gain.
doctor
Answered by Dr. Anders Mark Christensen (6 hours later)
Brief Answer:
Prostatitis most likely

Detailed Answer:
Hi again Davegova,

I agree that biopsies are premature at this point.

To answer your other questions:

1. Some of the symptoms are similar, but the pain and enlarged prostate argue against it, as prostate cancer only rarely leads to urination problems.

2. There is no reason to suspect a link between chronic prostatitis and prostate cancer.

Hope this helps.
Please let me know if you have further questions.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Anders Mark Christensen (0 minute later)
Brief Answer:
Prostatitis most likely

Detailed Answer:
Hi again Davegova,

I agree that biopsies are premature at this point.

To answer your other questions:

1. Some of the symptoms are similar, but the pain and enlarged prostate argue against it, as prostate cancer only rarely leads to urination problems.

2. There is no reason to suspect a link between chronic prostatitis and prostate cancer.

Hope this helps.
Please let me know if you have further questions.


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Anders Mark Christensen (15 hours later)
(I thought I replied already to this but now I see that my answer wasn't recorded by the system, so I will formulate again)

Until now I all I read about symptoms of ca prostate was urination problems, and the symptoms I have (testis pain, pelvic pain, lower back, need to pass bowel without being able to) was prostatis.

My question is in two parts:

1. The symptom I described, could they also be symptoms of cancer?

2. if the symtoms of cancer are not urination problem, then what are exactly the symptoms of cancer (when there is symptoms)?
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Follow up: Dr. Anders Mark Christensen (0 minute later)
(I thought I replied already to this but now I see that my answer wasn't recorded by the system, so I will formulate again)

Until now I all I read about symptoms of ca prostate was urination problems, and the symptoms I have (testis pain, pelvic pain, lower back, need to pass bowel without being able to) was prostatis.

My question is in two parts:

1. The symptom I described, could they also be symptoms of cancer?

2. if the symtoms of cancer are not urination problem, then what are exactly the symptoms of cancer (when there is symptoms)?
doctor
Answered by Dr. Anders Mark Christensen (1 hour later)
Brief Answer:
See my previous answer

Detailed Answer:
Hi XXXXXXX

I see I have just answered your question in a different thread. If you go up in the Q and A history you will find a thorough explanation and an argument for my opinion that biopsies are premature at this point.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Anders Mark Christensen (0 minute later)
Brief Answer:
See my previous answer

Detailed Answer:
Hi XXXXXXX

I see I have just answered your question in a different thread. If you go up in the Q and A history you will find a thorough explanation and an argument for my opinion that biopsies are premature at this point.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Anders Mark Christensen (31 minutes later)
Thank you Anders. Yes, I am sorry, I don't know why my first answer/question to your last response didn't appear here, then when I saw it was missing I re-posted it but after a while I thought that you were maybe sleeping, so I thought about posting it in another thread so someone on line could answer it. Maybe I will post now my new answer in the new tread. Thanks again.
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Follow up: Dr. Anders Mark Christensen (0 minute later)
Thank you Anders. Yes, I am sorry, I don't know why my first answer/question to your last response didn't appear here, then when I saw it was missing I re-posted it but after a while I thought that you were maybe sleeping, so I thought about posting it in another thread so someone on line could answer it. Maybe I will post now my new answer in the new tread. Thanks again.
doctor
Answered by Dr. Anders Mark Christensen (21 hours later)
Brief Answer:
No problem

Detailed Answer:
No problem XXXXXXX

I will look at it ASAP.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Anders Mark Christensen (0 minute later)
Brief Answer:
No problem

Detailed Answer:
No problem XXXXXXX

I will look at it ASAP.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Anders Mark Christensen (3 hours later)
Thanks a lot. In the meantime i have a more worrying concern but I think it may not be correct.

Elevated psa even 8 could be explained by just prostatitis and/or enlarged prostate, but someone told me that even so, the fact that the psa is raising me be cause for concern warrant biopsy, because according to him, a chronic prostatitis though may create an elevated psa, it does not raise.

I have my doubts because then why make a biopsy if a rising psa would automatically mean it is malign.

here is the progression for me, but all tell me it is reasonably slow and I think may be due also to the enlarged prostate growing.

is it true that elevated psa for chronic prostatitis does not rise?

Nov 07, 2018: 6.57
Dec 02, 2018: 5.41
Mar 03, 2019: 6.12
Jun 03, 2019: 7.16
Jun 10, 2019: 6.53
Oct 22, 2019: 7.59 XXXXXXX 26, 2020: 8.43
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Follow up: Dr. Anders Mark Christensen (0 minute later)
Thanks a lot. In the meantime i have a more worrying concern but I think it may not be correct.

Elevated psa even 8 could be explained by just prostatitis and/or enlarged prostate, but someone told me that even so, the fact that the psa is raising me be cause for concern warrant biopsy, because according to him, a chronic prostatitis though may create an elevated psa, it does not raise.

I have my doubts because then why make a biopsy if a rising psa would automatically mean it is malign.

here is the progression for me, but all tell me it is reasonably slow and I think may be due also to the enlarged prostate growing.

is it true that elevated psa for chronic prostatitis does not rise?

Nov 07, 2018: 6.57
Dec 02, 2018: 5.41
Mar 03, 2019: 6.12
Jun 03, 2019: 7.16
Jun 10, 2019: 6.53
Oct 22, 2019: 7.59 XXXXXXX 26, 2020: 8.43
doctor
Answered by Dr. Anders Mark Christensen (18 hours later)
Brief Answer:
Prostatitis still most likely

Detailed Answer:
Hi again XXXXXXX

A rise in psa does not necessarily mean that it is cancer. However, in my opinion, it does justify some imaging, e.g. transrectal ultrasound or MRI.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Anders Mark Christensen (0 minute later)
Brief Answer:
Prostatitis still most likely

Detailed Answer:
Hi again XXXXXXX

A rise in psa does not necessarily mean that it is cancer. However, in my opinion, it does justify some imaging, e.g. transrectal ultrasound or MRI.
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. Vaishalee Punj
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Dr. Anders Mark Christensen

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Practicing since :2016

Answered : 1561 Questions

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