What steps should be taken if PSA levels are elevated?

Question

Hello doctor,

I am 50 and recently had my annual check-up, where my PSA (prostate-specific antigen) was slightly elevated. My father had aggressive prostate cancer at 60, so I am worried this could be the start of the same for me. Should I ask for further tests or a biopsy now, or is it too soon? Are there preventive steps I can take, given my higher risk? Please help.

Thank you in advance.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Cancer occurs when abnormal cell growth disrupts the body's normal functions. Prostate cancer (a type of cancer that develops in the prostate, a small gland in the male reproductive system that produces semen) develops when abnormal cells grow in the prostate gland. Not all abnormal growths are cancerous; some are benign (non-cancerous). For example, benign prostatic hyperplasia (BPH) is not life-threatening and does not spread to other parts of the body. These growths can be removed and might not return.

Cancerous growths, like prostate cancer, can spread (metastasize) to nearby organs and tissues, such as the bladder, rectum, or other parts of the body. If the abnormal growth is removed, it could still return. Prostate cancer can be life-threatening if it spreads far beyond the prostate.

Treatment options

Active surveillance: This approach is ideal for small, slow-growing cancers. Your doctor will monitor the cancer through regular tests, including PSA (prostate-specific antigen), blood tests, biopsies, and possibly MRIs (magnetic resonance imaging). Active surveillance helps maintain a good quality of life by avoiding urinary, sexual, and bowel side effects. If PSA levels rise or a biopsy shows cancer growth, more aggressive treatment such as surgery or radiation therapy may be necessary.

Watchful waiting: Watchful waiting is used to monitor cancer without active treatment, and it does not involve regular PSA tests or biopsies. This approach is sometimes recommended for older men or those with other health issues that prevent surgery or radiation. The risk is that the cancer could spread between follow-up visits.

Surgery and radiation therapy:

The two main treatments for prostate cancer are surgery and radiation therapy, both with similar success rates. Your doctor can help determine which treatment is best suited for you.

Surgery: A radical prostatectomy involves removing the prostate, seminal vesicles, and nearby tissue, including lymph nodes. It requires anesthesia and a short hospital stay. However, surgery carries risks of intraoperative complications, early postoperative complications, and late complications.
Radiation therapy: Like surgery, radiation aims to eliminate the cancer but also has potential side effects.

I advise you to follow your doctor's plan, as they will regularly monitor your progress and take immediate action if the cancer progresses. There is no need to worry.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.