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Normal Psa With Enlarged Prostate

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High PSA & Prostatitis | Ask a Prostate Expert, Mark Scholz, MD

Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.

An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.

Using The Psa Blood Test After Prostate Cancer Diagnosis

Although the PSA test is used mainly to check for prostate cancer, it can also help your doctor:

  • Choose a treatment. Along with an exam and tumor stage, the PSA test can help determine how advanced a prostate cancer is. This may affect treatment options.
  • Check treatment success. After surgery or radiation, the doctor can watch your PSA level to see if the treatment worked. PSA levels normally fall if all of the cancer cells were removed or destroyed. A rising PSA level can mean that prostate cancer cells are present and your cancer has returned.

If you choose a watchful waiting approach to treatment, your PSA level can tell your doctor if the disease is progressing. If so, youâll need to think about active treatment.

During hormone therapy, the PSA level can show how well the treatment is working and when itâs time to try another treatment.

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What Is The Psa Test

Prostate-specific antigen, or PSA, is a protein produced by normal, as well as malignant, cells of the prostate gland. The PSA test measures the level of PSA in the blood. For this test, a blood sample is sent to a laboratory for analysis. The results are usually reported as nanograms of PSA per milliliter of blood.

The blood level of PSA is often elevated in people with prostate cancer, and the PSA test was originally approved by the FDA in 1986 to monitor the progression of prostate cancer in men who had already been diagnosed with the disease. In 1994, FDA approved the PSA test to be used in conjunction with a digital rectal exam to aid in the detection of prostate cancer in men 50 years and older. Until about 2008, many doctors and professional organizations had encouraged yearly PSA screening for prostate cancer beginning at age 50.

PSA testing is also often used by health care providers for individuals who report prostate symptoms to help determine the nature of the problem.

In addition to prostate cancer, several benign conditions can cause a persons PSA level to rise, particularly prostatitis and benign prostatic hyperplasia . There is no evidence that either condition leads to prostate cancer, but someone can have one or both of these conditions and develop prostate cancer as well.

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The Meaning Of Very Highly Elevated Psa

PSA 1000, is it possible, does it mean the mans death?First you have to confirm the lab result when it is above the normal limits.PSA levels 100+. Often show when Patients have advanced or metastatic prostate cancer.Very high PSA level usually mean strong indicator of multinodular prostate cancer and removal after biopsy.What is the PSA level to remove prostate?Prostate cancer removal depends on the pathological report of a biopsy taken from your prostate gland to decide the extension, shape, volume, and properties of the suspected cancerous cells, PSA are only used to monitor the progress of suspicious cells, then decide a biopsy procedure. However, highly elevated PSA total with low free PSA levels is a strong prostate cancer marker and a result required fast medical decision.Elevated High PSA after prostatectomy?A careful handling of PSA values after prostate removal is must,after prostatectomy you must wait for about six weeks to take a blood PSA test, because PSA levels are commonly show elevated after surgery, but its a false PSA result, however repeating the test after some weeks can declare if its just false or it may a cause of incomplete surgery or dangerous remnants of cancer cell.Now I think you understanding what does a high PSA test mean?Dont miss, What should my PSA level be in my previous interpretation about Normal PSA Levels

Fruit And Fruit Extracts

Prostatitin

Fruits are rich sources of phytochemicals carrying multiple antioxidant and anti-inflammatory properties, and for this, a diet rich in fruits is often recruited to reduce oxidative stress in conditions with an elevated inflammatory state . In parallel, fruit extracts derived usually via exploitation of fruit residues are often used in phytomedicine as nutraceuticals with postulated cancer-related outcomes . In BPH and PCa, in particular, apart from antioxidant and anti-inflammatory properties, fruits and fruit extracts are also expected to exhibit antiproliferative, anti-androgenic, and anti-estrogenic properties .

Cranberries are rich in bioactive compounds , including organic and phenolic acids, flavonoids and flavonoid glycosides, ursane triterpenoids, anthocyanins and proanthocyanidins , with many preclinical studies advocating for their effectiveness as an adjuvant PCa therapy . One RCT examined the effects of daily cranberry powder ONS compared with placebo on men with PCa, revealing a 22.5% reduction of PSA concentrations in the cranberry intervention arm after 30 days of supplementation. As far as PCa risk is concerned, another Czech RCT evaluated the efficacy of cranberry powder ONSwithout a comparator, reporting a reduction in PSA after 6 months of daily intake among men with lower urinary tract symptoms , elevated PSA, but negative prostate biopsy .

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Where Does Prostate Cancer Spread

The most common place for prostate cancer to spread to is the bones. It can also spread to the:

A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.

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Postvoid Residual Urine Volume

PVR is the volume of fluid remaining in the bladder immediately after the completion of micturition. Studies indicate that residual urine volume normally ranges from 0.09 mL to 2.24 mL, with the mean being approximately 0.53 mL.28 Seventy-eight percent of healthy men have PVRs of less than 5 mL, and 100% have volumes of less than 12 mL.29

PVR measurement can be performed by noninvasive or invasive methods. The most common method is ultrasonography. Small, portable, 3-dimensional ultrasound devices are widely used to measure PVR in the office setting. The reported accuracy of these devices is comparable to that of more expensive ultrasound units and catheterization. In one study, the correlation coefficient between PVR as determined by catheterization versus ultrasonography with a portable device was 0.79.30 Over the years, the clinical performance of this 3-dimensional technology has evolved to out-perform large, stationary ultrasound.31

Birch and colleagues32 reported that, of 30 men with BPH, 66% had wide variations in PVR when 3 measurements were taken on the same day. In 34% of subjects, there was no difference among the 3 measurements. In 58% of subjects, at least 2 volumes were significantly different. In 8% of patients, all 3 volumes were different. In most patients, 2 measurements were statistically similar, whereas the third yielded quite different results.

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Does My Psa Level Determine Whether I Have Prostate Cancer

Your provider looks at two factors related to your PSA:

  • Your PSA level: A higher level means a higher risk of prostate cancer.
  • A continuous rise: PSA levels that continue to rise after two or more tests may mean you have cancer.

But the PSA level alone doesnt determine if you have cancer or not. Two men can even have the same PSA levels but different risks of prostate cancer. And a high PSA level may reflect prostate problems that arent cancer.

What Is A Normal Psa Test Result

Prostate cancer and PSA test results: what happens next?

There is no specific normal or abnormal level of PSA in the blood. In the past, PSA levels of 4.0 ng/mL and lower were considered normal. However, some individuals with PSA levels below 4.0 ng/mL have prostate cancer and many with higher PSA levels between 4 and 10 ng/mL do not have prostate cancer .

In addition, various factors can cause someones PSA level to fluctuate. For example, the PSA level tends to increase with age, prostate gland size, and inflammation or infection. A recent prostate biopsy will also increase the PSA level, as can or vigorous exercise in the 2 days before testing. Conversely, some drugsincluding finasteride and dutasteride, which are used to treat BPHlower the PSA level.

In general, however, the higher a mans PSA level, the more likely it is that he has prostate cancer.

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Special Types Of Psa Tests

The PSA level from a screening test is sometimes referred to as total PSA, because it includes the different forms of PSA . If you decide to get a PSA screening test and the result isnt normal, some doctors might consider using different types of PSA tests to help decide if you need a prostate biopsy, although not all doctors agree on how to use these tests. If your PSA test result isnt normal, ask your doctor to discuss your cancer risk and your need for further tests.

Percent-free PSA: PSA occurs in 2 major forms in the blood. One form is attached to blood proteins, while the other circulates free . The percent-free PSA is the ratio of how much PSA circulates free compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not.

If your PSA test result is in the borderline range , the percent-free PSA might be used to help decide if you should have a prostate biopsy. A lower percent-free PSA means that your chance of having prostate cancer is higher and you should probably have a biopsy.

Many doctors recommend a prostate biopsy for men whose percent-free PSA is 10% or less, and advise that men consider a biopsy if it is between 10% and 25%. Using these cutoffs detects most cancers and helps some men avoid unnecessary biopsies. This test is widely used, but not all doctors agree that 25% is the best cutoff point to decide on a biopsy, and the cutoff may change depending on the overall PSA level.

What Have Randomized Trials Of Prostate Cancer Screening Found

Several large, randomized trials of prostate cancer screening have been carried out. One of the largest is the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which NCI conducted to determine whether certain screening tests can help reduce the numbers of deaths from several common cancers. In the prostate portion of the trial, the PSA test and digital rectal exam were evaluated for their ability to decrease a mans chances of dying from prostate cancer.

The PLCO investigators found that men who underwent annual prostate cancer screening had a higher incidence of prostate cancer than men in the control group but had about the same rate of deaths from the disease . Overall, the results suggest that many men were treated for prostate cancers that would not have been detected in their lifetime without screening. Consequently, these men were exposed unnecessarily to the potential harms of treatment.

A second large trial, the European Randomized Study of Screening for Prostate Cancer , compared prostate cancer deaths in men randomly assigned to PSA-based screening or no screening. As in the PLCO, men in ERSPC who were screened for prostate cancer had a higher incidence of the disease than control men. In contrast to the PLCO, however, men who were screened had a lower rate of death from prostate cancer .

The United States Preventive Services Task Force has estimated that, for every 1,000 men ages 55 to 69 years who are screened for 13 years :

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Understanding Psa Levels & The Psa Test

The prostate is a walnut-sized gland found between the bladder and the rectum in males. Its primary job is to produce seminal fluid. The prostate creates a protein, the prostate-specific antigen, or PSA. A PSA screening test is a blood test approved by the FDA in 1994 to measure the levels of PSA in a mans blood.

Small amounts of PSA ordinarily circulate in the bloodstream and can be measured by a PSA test to monitor the health of the prostate. This test is intended to screen for prostate cancer, find other prostate-related conditions, or monitor PSA levels in those in treatment for prostate cancer. This is a simple blood test which reports PSA levels as nanograms of PSA per milliliter of blood.

What Do Your Test Results Mean

What Is A Normal Psa Level After Prostate Removal

In general, the higher your PSA level and the lower your free PSA level, the greater your risk of having prostate cancer. Ranges are determined by age. As you get older, your PSA levels will normally rise, even if you dont have prostate cancer.

Doctors also look at other aspects of PSA, including:

  • PSA velocity. Changes in your PSA levels, called PSA velocity, are another consideration. If your PSA levels rise rapidly, your risk of prostate cancer is greater.
  • Doubling. The faster your PSA doubles, the greater your risk of more aggressive prostate cancer. Doctors also use doubling time to determine if prostate cancer has spread in men who already have been diagnosed with the disease.

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What If My Psa Is High

PSA screening is just the first step, alerting you and your doctor that more testing may be needed. If PSA is only slightly elevated, your doctor may recommend repeating the test a couple of weeks later. From there, other types of tests can help with the decision on whether you need a biopsy, including:

  • Digital rectal exam , if not already done
  • PSA velocity, or the rate of rise over time
  • PSA density, or the PSA per volume of prostate
  • PSA-based markers
  • Other markers, a urinary PCA3 or SelectMDx test
  • Magnetic resonance imaging of the prostate

Each time you see your doctor for a checkup, have a conversation about prostate health and prostate cancer screening. PCF recommends that you make a about PSA screening with your doctor, starting at age 45, or age 40 if you have a family history of prostate or other cancers or are Black.

What Is Prostate Intraepithelial Neoplasia Or Atypical Or Suspicious Cells On Biopsy

In about 10% of prostate needle biopsy reports, the pathologist will tell us that the final diagnosis is neither benign nor malignant. They describe this condition as

  • High Grade Intraepithelial Neoplasia
  • A premalignant condition
  • Biopsy should be repeated soon
  • 25% risk of cancer on repeat biopsy
  • Low Grade Intraepithelial Neoplasia
  • Repeat biopsy is not indicated unless there is a rise in PSA

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Best Vitamins To Shrink Enlarged Prostate Naturally

Today, we look at what happens when theres excessive cell growth in the prostate in men and the vitamins that help shrink an enlarged prostate.

Benign prostatic hyperplasia is a health condition characterized by an enlarged prostate. It may also be referred to as benign prostatic hypertrophy.

Hyperplasia and hypertrophy are simply fancy ways to describe excessive cell growth.

The prostate develops benign nodes that grow in such a way that they squeeze the urethra the tube that allows urine to exit the bladder and trigger bladder problems.

The prostate gland is located between the lower part of the bladder and the rectum and wraps around the urethra.

Imagine a normal walnut-sized prostate that can grow to the size of a lemon while clamping on the urethra, and Im sure you can picture the problem.

What Is Done If A Screening Test Shows An Elevated Psa Level

What is a Normal PSA Test?

If someone 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 person continue with PSA tests and digital rectal exams at regular intervals to watch for any changes over time .

If the PSA level continues to rise or a suspicious lump is detected during a DRE, the doctor may recommend additional tests to determine the nature of the problem. These may include imaging tests, such as magnetic resonance imaging or high-resolution micro-ultrasound.

Alternatively, the doctor may 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. The biopsy needle may be inserted through the wall of the rectum or through the perineum . A pathologist then examines the collected tissue under a microscope. Although both biopsy techniques are guided by ultrasound imaging so the doctor can view the prostate during the biopsy procedure, ultrasound cannot be used alone to diagnose prostate cancer. An MRI-guided biopsy may be performed for patients with suspicious areas seen on MRI.

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Urethroscopy/imaging Of The Upper Urinary Tract

Urethroscopy and imaging of the upper urinary tract should be performed only if the LUTS are accompanied by a UTI, hematuria, or a positive urinary cytologic finding. Men with LUTS and no evidence of hematuria are at no greater risk for renal tumors or other upper tract abnormalities. There are no endoscopic findings that link LUTS to a prostatic origin.

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