What should I do next ?

I am A 52 y/o male that had a physical last week and was told my PSA came back at a 7 with the standard PSA test. The DRE showed no abnormality in the prostate itself. I have absolutely no sysmptoms of prostate cancer. I have an appointment scheduled with a urologist on Friday. What can I expect the urologist to do on Friday ? I have been reading on the internet about PSA, prostate cancer etc ever since I received these results. From some of the websites I have been looking at it appears that a PSA test may be inaccurate if ejaculation occurred within 2 days of the test being performed. That was certainly the case with me since nobody told me I could not have sex prior to the testing. Also, I have learned about another test called F-PSA that is more accurate. On Friday, I would expect that the urologist would only do another DRE, another PSA and a F-PSA test to confirm as much as they can that the initial reading was accurate. Should I be anticipating anything else to happen on Friday ?

Obviously this news would be very disturbing and worrisome to everyone but in my case my wife also has battled breast cancer two times. With a teenage daughter at home this could be devastating to her. I have not yet told my wife about this because I do not want to place undue worry on her. Wish me luck with this one !

[Kevin Pho, MD]

There can be several reasons for an elevated PSA other than cancer.  This can include benign prostatic hypertrophy, a prostate infection, or even after a DRE.  

A free-PSA can be done.  The ratio can be used to determine the probability of cancer.  

A more definitive diagnosis can be made via prostate biopsy to rule out the possibility of cancer.  

I would expect that a DRE to be performed, as well as obtaining a repeat PSA and a free-PSA level.  Further tests like a transrectal ultrasound and prostate biopsy would be at the discretion of your urologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[pauld315]

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