Prostate Cancer

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How likely is it that the MRI could have missed significant cancer?

Query: Hello doctor, I am a 65-year-old with a very enlarged prostate (approx 100 ccs). I had periodic hematuria. PSA has vacillated between 2.7 and 5. Blind biopsy negative. I had two prostate MRI six months apart, one designated pirad 1 and the second pirad 2. I am on flow max and Finasteride. Based on ...  Read Full »

Dr. Gajanan Bhat

General Surgeon, Urologist

Answer: Hello, Welcome to With your description, it is obvious that you have a large prostate with lower urinary tract symptoms, which you are on treatment with Finasteride for more than six months. With this scenario, PSA (prostate-specific antigen) should be read as twice the value that is ...  Read Full »

What causes abnormal free PSA results?

Query: Hello doctor, 50 years old, 5.8 inches, 260 lbs. On blood pressure pills. My doctor is out of town for a few weeks. I reviewed PSA test results and apparently I have one abnormal reading out of three. PSA total 0.5, PSA free 0.1, PSA % free 20. The PSA % free 20 is in red indicating abnormal. What ...  Read Full »

Dr. Saurabh S Pandya


Answer: Hi, Welcome to Free PSA should be more than 15 % to rule out prostate cancer. Free PSA is an additional tool used when PSA is above 2.5 and we want to check whether high PSA is due to benign prostate growth or due to prostate cancer. Some laboratories use 25 % cutoff, but most have 15...  Read Full »

I have frequent urination and minimal calcification. Does it mean prostate cancer?

Query: Hi doctor, I am 27 years old. I am worried about my prostate as my grandfather had prostate cancer and my father had an enlargement but was already cured. I had an ultrasound last year due to frequent urinating and result showed minimal calcification a year back. The Radiologist told me that the ca...  Read Full »

Dr. Karthik Rajan

Urologist, Andrologist

Answer: Hi, Welcome to I have gone through your query. It is extremely unlikely for you to develop prostate cancer at your age. Even in families with hereditary prostate cancer, the usual age people develop cancer is above 40 years of age at the lowest, though it is usually between 50 to 60 y...  Read Full »

Please enlighten me on non-invasive procedures to detect prostate cancer.

Query: Hello doctor, I am a 79 year old male. Excellent health, take no medications with the exception of an occasional Viagra. In a recent DRE, my urologist discovered two small nodules on my prostate. A PSA at the time was 6.3. Over the years, I have ranged in 2's and 3's. He suggested a biopsy of the p...  Read Full »

Dr. Karthik Rajan

Urologist, Andrologist

Answer: Hi, Welcome to I have gone through your query. I concur with your urologist in the need for a biopsy. Any PSA (prostate-specific antigen) more than 4 or abnormal findings on DRE (digital rectal examination) needs evaluation to rule out prostate cancer. None of the non-invasive te...  Read Full »

Can prostate cancer only be treated through surgery?

Query: Hi doctor, My father is 58 years old. He suffers from frequent urination and urgency to urinate. An ultrasound, blood tests, biopsy, and a bone scan was conducted. Bone scan did not show any metastasis. He was advised to take a pelvis MRI 15-20 days after the biopsy. He was diagnosed with prostate ...  Read Full »

Dr. Raghu

General Surgeon, Surgical Oncologist

Answer: Hi, Welcome to From the reports submitted (attachment removed to protect patient identity), it is clear that your father has prostate cancer. From MRI, we can know the exact size of the tumor. It will also help in staging and we can get to know is there any spread to the nearby lymph...  Read Full »

Had a prostate biopsy as the PSA level was high. What does the report say?

Query: Hi doctor, The patient is a 59-year-old male with whose weight is 52.3 kg and height is 166 cm. His PSA was 247.5. He had a TRUS guided biopsy, and the report is as follows. 1. Moderately differentiated adenocarcinoma.2. Gleason grade 4+4.3. Perineural invasion present. What does the biopsy repor...  Read Full »

Dr. Raguram Ganesamoni

Andrologist, Urologist

Answer: Hi, Welcome to I am sorry to know about the problem. The biopsy report says that prostate has a cancer disease. Since PSA is very high, it means that there is a chance that it has spread outside the prostate. The next step will be PSMA PET scan to find out the areas in the body affec...  Read Full »

Why are there drops of blood in my urine?

Query: Hello doctor, I am 79 years old male and in good health. But, since a few days, I have a few drops of blood in my urine. Please tell me the probabilities of a problem and tell me what I should do. About 7 years ago, I had an operation on my prostate to ease the urination. For about a year or more a...  Read Full »

Dr. Mahmoud Ahmed Abelrahman Abouibrahim

Internal Medicine Physician, Family Physician, General Practitioner, General Medicine Physician

Answer: Hi, Welcome to Painless blood in the urine has two possible causes. The first is cancer bladder and the second is prostate cancer or hyperplasia. What is the nature of the operation you did in the prostate? Was it benign prostate hyperplasia? Is there any painful urination or history ...  Read Full »

Is the rise in PSA value related to hemorrhoid vein thrombosis?

Query: Hi doctor,My query is related to PSA values. Please look into the attachment. The person is currently suffering from a thrombosed hemorrhoid vein. The treatment which the doctor has proposed is Movicol a stool softener 1-0-0, Daflon 2-2-2-0 for the first four days and afterwards for three more days...  Read Full »

Dr. Muhammad M. Hanif Md.

Cardiologist, Criticalcare Physician, General Medicine Physician, Internal Medicine Physician

Answer: Hi, Welcome to I have thoroughly gone through your case and can well understand your genuine health concerns.  Read Full »

Will surgery for BPH prevent prostate cancer?

Query: Hello doctor, This query is regarding my father. He is 65 years old. He suffers from BPH from the last five years and takes Alfusin-D for the same. Five years back, when he was diagnosed, his PSA was 2.8 ng. Last year, we repeated his test and the PSA was 0.9 ng/ml with normal DRE. An ultrasound of ...  Read Full »

Dr. Devendra


Answer: Hello, Welcome to The PSA (prostate-specific antigen) has decreased due to Dutasteride component of Alfusin-D. I suggest he get the screening done yearly for a year or two. Then, a two-yearly screening of PSA and DRE (digital rectal examination) is alright as his PSA is low in spite of...  Read Full »

My father was diagnosed with prostatic adenocarcinoma. What should we do?

Query: Hello doctor, My father is diagnosed with prostatic adenocarcinoma. His biopsy reports show Gleason's grade 3+4 (% of 4 is 30%), tumor involves 60 % of submitted biopsy. No perineural invasion is seen. His PSA level is 107.69 ng/mL. He has triple vessel heart disease, and the echo result showed EP...  Read Full »

Dr. Bharat Patodiya

Family Physician, General Medicine Physician, General Practitioner, Internal Medicine Physician, Medical Oncologist

Answer: Hello,Welcome to can get a staging workup with PSMA (prostate-specific membrane antigen) scan or bone scan and MRI pelvis. His high PSA (prostate-specific antigen) does make him high risk, but considering his age, I will not suggest a very aggressive approach to the case.If the prost...  Read Full »

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