How do I identify the warning signs of prostate cancer?

Question

Hello doctor,

I am here because I am worried about my friend. He is 55 years old, and last month he mentioned he was feeling pretty tired all the time and needing to pee a lot, especially at night. At first, he laughed it off as "just getting older," but his wife pushed him to get checked. His doctor said his PSA levels were elevated and suggested a biopsy, which scared him. Also, he has not told a lot of people, but he confided in me because he is scared it might be prostate cancer. I do not think he is sleeping much; he has been skipping work a lot and does not seem like himself these days.

I am not an expert, but it seems like this whole thing is weighing on him even before there is a diagnosis.

What I am asking is, how serious does this sound?
Could those high PSA levels mean something else, or do they almost always point to cancer?
And if it is cancer, what is the usual game plan?
Are treatments pretty effective at this stage?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

If PSA (prostate-specific antigen) is elevated and the biopsy is not conclusive, then an MRI (magnetic resonance imaging) of the prostate gland may be taken, followed by repeated biopsy (a procedure done to remove tissue or cells from the body for examination under a microscope) if needed.

How high was his PSA? Because PSA can be mildly increased in other conditions, including prostatitis, BPH (benign prostatic hyperplasia), etc., PSA has to be repeated twice with an interval of two weeks.

Usually, prostate cancer is a slow-growing cancer in old age where PSA has been found to be high. The next step will be to do an MRI pelvis or transrectal ultrasound (an imaging procedure that uses sound waves to examine the prostate and surrounding tissues) of the prostate and a biopsy of the prostate gland.

Once the biopsy report is available, we will be able to say whether it is an aggressive form of prostate cancer or a slow-growing cancer.

Treatment depends upon the biopsy report and PSMA PET (prostate-specific membrane antigen positron emission tomography) scan report.

Some patients need just close observation while others need surgery or hormonal therapy.

I hope this helps.

Thank you, and take care.

Regards.