Monday, May 23, 2022

Does Size Of Prostate Affect Psa

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What Is Acute Prostatitis

Does Your Prostate Size Matter? | Mark Moyad, MD MPH & Mark Scholz, MD at the PCRI Conference 2019

The prostate is a walnut-sized gland that sits below the bladder in men. This gland makes fluid that mixes with sperm to form semen. Because the prostate surrounds the urethra , conditions that cause the prostate to swell or enlarge may press on the urethra and cause pain or problems with urination.

Prostatitis is inflammation of the prostate gland. Acute prostatitis is inflammation of the prostate gland that results in sudden onset of symptoms. Acute prostatitis is caused by an infection, usually by bacteria that get into the prostate by traveling up the urethra. Some of these bacteria are the normal germs that live on and inside your body. Other infections are transmitted through sexual contact.

Most men who will develop prostatitis have a normal prostate gland, although the infection may be more common in older men as the gland gets larger with age. There is no known link between prostatitis and prostate cancer.

How Should The Psa Test Be Used For The Early Detection Of Prostate Cancer

Ultimately, the decision to use PSA for the early detection of prostate cancer should be individualized. Men should be informed of the known risks and the potential benefits of early screening. Not all men are appropriate candidates for screening efforts. For instance, screening in men with less than a 10-year life expectancy, either due to age or other illness, is discouraged as there will be most likely no benefit for them.

If prostate cancer is detected on prostate biopsy, all treatment options should be discussed. The benefits and risks of the many treatment options should be reviewed and discussed with men found to have prostate cancer. The AUA recommends that this discussion include active surveillance in men with low-risk prostate cancer. The goal of active surveillance is to allow men to maintain their quality of life when the disease is slow-growing or inactive but still allow them to be cured of prostate cancer when the disease appears to become more aggressive or is fast-growing. Other novel biomarkers, such as PCA3 , may assist the clinician in these decisions.

What Are Psa Levels

Cells in the prostate gland produce PSA, and levels typically remain below 4 nanograms per milliliter .

Most individuals with prostate cancer have PSA levels above 4 ng/mL. However, some men with prostate cancer have a normal PSA level. Similarly, some men with a higher than average PSA do not have prostate cancer.

These variations mean that a PSA test alone cannot rule out or diagnose prostate cancer. However, the PSA test can identify whether a person has a higher risk of developing the disease.

Initial testing may include both a PSA test and a DRE.

During a DRE examination, a doctor inserts a finger into the rectum to check the prostate for anomalies.

If both of these tests suggest prostate cancer, then the doctor will arrange for a biopsy to confirm the diagnosis.

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Ejaculation Is A Potential Cause Of Mildly Elevated Psa

“Ejaculation can cause a mild elevation of your PSA level, and so can having a digital rectal exam,” says Milner. “These types of PSA elevations are usually not enough to make a significant difference unless your PSA is borderline. PSA should return to normal in two to three days.”

To avoid this type of elevation, doctors will usually draw blood for a person’s PSA level before doing a rectal exam. Ask your doctor if you should avoid ejaculation for a few days before a PSA test.

Signs And Symptoms Of Prostate Cancer

Benign prostate enlargement

Most prostate cancers are found early, through screening. Early prostate cancer usually causes no symptoms. More advanced prostate cancers can sometimes cause symptoms, such as:

  • Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
  • Blood in the urine or semen
  • Trouble getting an erection
  • Pain in the hips, back , chest , or other areas from cancer that has spread to bones
  • Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord

Most of these problems are more likely to be caused by something other than prostate cancer. For example, trouble urinating is much more often caused by benign prostatic hyperplasia , a non-cancerous growth of the prostate. Still, its important to tell your health care provider if you have any of these symptoms so that the cause can be found and treated, if needed. Some men might need more tests to check for prostate cancer.

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Soreness In The Groin

When prostate cancer spreads, its common for cancer cells to go to your lymph nodes and then move to more areas of your body. The lymph nodes are a network of glands that help your body filter fluids and fight infections.

There are several lymph nodes in your groin. These are the ones closest to your prostate, so its common for the cancer to spread to them first. Cancer cells prevent your lymph nodes from draining fluid and working properly. When this happens, your lymph nodes swell. As a result, you might experience pain or soreness in the area.

How Will My Veterinarian Get These Samples

A free-flow urine sample iscollected . Samples of prostatic fluid are obtained by passing a urethral catheter to the level of the prostate and massaging the prostate to milk fluid out of it.

Samples of prostatic cells are obtained by fine needle aspiration or biopsy. If the prostate is greatly enlarged, it may be sampled by through the body wall by FNA or biopsied. FNA involves taking a small needle with a syringe and suctioning a sample of cells directly from the prostate and placing them on a microscope slide. A veterinary pathologist then examines the slide under a microscope. In some cases, results from FNA may not be entirely clear and biopsy may be necessary.

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What Other Problems Might An Enlarged Prostate Cause

A small number of men may find it difficult to empty their bladder properly this is called urine retention. If youve been diagnosed with an enlarged prostate, your doctor will look at your test results to see if youre at risk of urine retention. You may be more likely to get urine retention if:

  • youre aged 70 or over
  • your prostate is very large
  • you have a raised prostate specific antigen level
  • you have severe urinary symptoms and a very slow flow.

Chronic urine retention

This is where you cant empty your bladder fully, but can still urinate a little. It usually develops slowly over time. Chronic means long-lasting. The first signs often include a weak flow when you urinate, or leaking urine at night. You may feel that your abdomen is swollen, or that youre not emptying your bladder fully.

Chronic urine retention is usually painless. But the pressure of the urine can slowly stretch your bladder muscle and make it weaker. This can cause urine to be left behind in the bladder when you urinate. If you dont empty your bladder fully, you might get a urine infection, need to urinate more often, leak urine at night, or get painful bladder stones. You might also see some blood in your urine. Chronic urine retention can damage your bladder and kidneys if it isnt treated.

There are treatments for chronic urine retention, including:

  • passing a thin, flexible tube called a catheter to drain urine from your bladder
  • surgery to widen the urethra.

Acute urine retention

What Are Some Of The Limitations And Potential Harms Of The Psa Test For Prostate Cancer Screening

What Is a Normal PSA for a Man Without Prostate Cancer? | Ask a Prostate Expert, Mark Scholz, MD

Detecting prostate cancer early may not reduce the chance of dying from prostate cancer. When used in screening, the PSA test can help detect small tumors that do not cause symptoms. Finding a small tumor, however, may not necessarily reduce a mans chance of dying from prostate cancer. Many tumors found through PSA testing grow so slowly that they are unlikely to threaten a mans life. Detecting tumors that are not life-threatening

that requires treatment.

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Chronic Pelvic Pain Syndrome

Just as IBS can cause prostatitis, so prostatitis can cause IBS. Chronic pelvic pain syndrome , a longstanding and habitual tightening of the pelvic muscles due to stress, can cause both conditions 1. Doctors are just beginning to research CPPS as a cause for the overlapping symptoms of prostatitis and IBS. The early findings from a study by Dr. David Wise at Stanford University are that a program of stretching, massage and relaxation exercises can all be beneficial in CPPS management. Before going on medications or electing to undergo surgery, ask your doctor whether CPPS might be the cause of your discomfort.

  • Just as IBS can cause prostatitis, so prostatitis can cause IBS.
  • Doctors are just beginning to research CPPS as a cause for the overlapping symptoms of prostatitis and IBS.

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What Factors Can Impact Psa Level

Several conditions can lead to an elevated PSA level, not just prostate cancer.

As men grow older, many are affected by prostatitis, an inflammation of the prostate, or benign prostatic hyperplasia , a non-cancerous enlargement of the prostate which causes PSA levels to rise. Ejaculation, male hormone medications, and some urologic procedures can also lead to an elevated reading.

Additionally, PSA levels tend to slowly rise with age, even if there is no abnormality within the prostate.

There are several factors that may cause a lowered PSA level as well. Patients who are overweight, frequently take aspirin, or use certain cholesterol-lowering drugs may see misleadingly low changes in their PSA levels.

Similarly, medication for the urinary symptoms of BPH, such as finasteride or dutasteride, may cause misleadingly low PSA levels.

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How Are Researchers Trying To Improve The Psa Test

Scientists are investigating ways to improve the PSA test to give doctors the ability to better distinguish cancerous from benign conditions and slow-growing cancers from fast-growing, potentially lethal cancers. None has been proven to decrease the risk of death from prostate cancer. Some of the methods being studied include:

What Is The Cost Of The Psa Test

A Primer on Prostate

The PSA blood test is frequently covered by insurance, especially for men who are 50 years of age and older. PSA blood tests costs $20-$50. However, if it is obtained in the doctor’s office during a visit to the doctor there may be an additional charge of $25-$100 for the office visit. There are PSA blood tests available for home use. The home blood test comes with a lancet to prick your finger and squeeze out a sample of blood, a kit to collect the blood, a bandage, and an address or prepaid mailer to return to the laboratory. Not all of the advertised home blood tests are approved by the U.S. Food and Drug Administration . You can access the FDA web site to make sure you are using an approved test.

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Using Medication To Reduce Symptoms

  • 1Recognize the symptoms of an enlarged prostate. Look for a weak stream of urine, dribbling at the end of urination, or an increased need to urinate at night. You may also have difficulty starting urination or need to strain to empty your bladder. If you notice these symptoms, make an appointment with your doctor for an official diagnosis.XTrustworthy SourceMayo ClinicEducational website from one of the worlds leading hospitalsGo to source
  • 2Try alpha-blockers if you have trouble urinating. Talk to your doctor about alpha-blockers, which can relax muscles around the bladder and prostate. These drugs help increase the flow of urine when you use the bathroom and keep you from needing to urinate too frequently.XResearch source
  • While adverse side effects are infrequent, alpha-blockers can cause dizziness. The good news is, they typically help relieve symptoms within a few weeks.
  • Take alpha-blockers, like tamsulosin, as directed by your doctor.
  • Most alpha-blockers are safe to take with other medications. Consult your pharmacist for any potential drug interactions with your current medication regimen.
  • 3Explore enzyme-inhibitors if you have a very enlarged prostate. Ask your doctor if enzyme-inhibitors, like finasteride and dutasteride, would be a good fit for your symptoms. These drugs shrink prostate tissue to reduce urinary problems and are often most effective on severely enlarged prostates.XResearch source
  • Like alpha-blockers, dizziness is the most common side effect.
  • In Men Over : Bph May Be The Cause Of High Psa

    Benign prostatic hyperplasia is an enlargement of the prostate gland, but its not prostate cancer. “BPH means more cells, so that means more cells making PSA,” explains Dr. Castle.

    BPH is the most common prostate problem in men over age 50. It may not need to be treated unless its causing frequent or difficult urination.

    Your primary care doctor may be able to tell the difference between BPH and prostate cancer by doing a digital rectal exam, but commonly this will require evaluation by a urologist and further testing, such as a biopsy or imaging studies.

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    What Is Considered An Elevated Prostate

    Researchers havent settled on a single normal PSA level. Previously, a level of 4.0 ng/mL or higher would lead to more testing, usually a prostate biopsy. During the biopsy, a healthcare provider removes a small sample of prostate tissue to check it for cancer.

    However, healthcare providers now consider other issues together with the PSA level to decide whether to perform a biopsy. Your age, general health, family history and health history factor into the decision.

    What Causes An Enlarged Prostate

    Does a DRE or Biopsy Affect PSA, Does Erleada Affect PSA | Answering Comments Mark Scholz, MD #15

    We still dont really know all the things that cause the prostate to grow. But we do know about two risk factors that can increase your risk of having an enlarged prostate.

    Age

    Your risk of having an enlarged prostate increases as you get older. Many men aged 50 or over have an enlarged prostate, but they dont all get symptoms. And some men have symptoms that don’t bother them.

    Hormone levels

    The balance of hormones in your body changes as you get older. This may cause your prostate to grow.

    Other factors

    Some studies show that obese men and men who have diabetes may be more likely to develop an enlarged prostate. Regular exercise may help to reduce your risk of urinary symptoms. But we still need more studies into the causes of enlarged prostate to know for certain if, and how, we can prevent it.

    There is also some research that suggests you may be more at risk of developing an enlarged prostate if your father or brother has one. Again, further studies are needed to confirm this.

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    What If A Screening Test Shows An Elevated Psa Level

    If a man who has no symptoms of prostate cancer chooses to undergo prostate cancer screening and is found to have an elevated PSA level, the doctor may recommend another PSA test to confirm the original finding. If the PSA level is still high, the doctor may recommend that the man continue with PSA tests and DREs at regular intervals to watch for any changes over time.

    If a mans PSA level continues to rise or if a suspicious lump is detected during a DRE, the doctor may recommend additional tests to determine the nature of the problem. A urine test may be recommended to check for a urinary tract infection. The doctor may also recommend imaging tests, such as a transrectal ultrasound, x-rays, or cystoscopy.

    If prostate cancer is suspected, the doctor will recommend a prostate biopsy. During this procedure, multiple samples of prostate tissue are collected by inserting hollow needles into the prostate and then withdrawing them. Most often, the needles are inserted through the wall of the rectum . A pathologist then examines the collected tissue under a microscope. The doctor may use ultrasound to view the prostate during the biopsy, but ultrasound cannot be used alone to diagnose prostate cancer.

    Ejaculation Frequency And Prostate Cancer

    Despite the importance of prostate cancer, its causes remain unknown. Scientists do know that genetics plays a strong role, and they have sound evidence that diet and other lifestyle factors are also important.

    Since the prostate is a reproductive organ that produces fluid for the ejaculate, researchers have long wondered if sexual factors influence a mans risk of prostate cancer, but a Harvard study provides good news for sexually active men.

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    Cell Cycle Inhibitor P27

    The cell cycle inhibitor p27 is a putative tumor suppressor gene. Loss of p27 is associated with a poor prognosis in patients with breast, colorectal, and prostate carcinoma. In men treated with radical prostatectomy, loss of p27 expression correlates with an increased probability of cancer recurrence and lower survival rates. Decreased p27 expression also is associated with high-grade cancer cells, positive surgical margins, seminal vesicle invasion, and lymph node metastases.

    Can Prostate Massage Really Help An Enlarged Prostate

    Prostate Conditions: What You Need to Be Aware Of

    Prostate milking, or prostate massage, has the ability to give men intense relief from prostate problems. The prostate, or the prostate gland is a major organ in the male reproductive system.

    The primary function of this gland is to produce prostatic fluid. This is the fluid that helps the sperm survive after ejaculation.

    Unfortunately, factors like aging and a poor lifestyle can make the prostate weak. This results in an impairment in urinary function, sexual function and prostate inflammation.

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    However, by massaging the prostate on a regular basis, blood flow increases in the area. The pain that is related to an inflamed prostate as well as discomfort in the area diminishes.

    It is important to know that prostate massage is not a new practice. It is a treatment that has been utilized for thousands of years in Asian culture, and it is still a treatment that is used today.

    In fact, many men have reported feeling much better after one prostate massage session.

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