Watching the PSA and avoiding prostate cancer. What you need to know.

As men get older we need to make sure that we are paying attention to our prostates. I always say to my patients, that sooner or later we come to a point where some difficult questions have to be answered. That’s because prostate cancer increases as we age and is the most common cancer that men will face in our lives. The older you become, especially for black men, the concerns become even more significant.  About 1 in 8 men will get prostate cancer during their lifetime. It is the most common cancer for men and second leading cause of cancer deaths. Fortunately, most men who get prostate cancer do not die from it.  This slow growing cancer currently has no definitive way to be prevented but you can lessen your risk with a healthy diet and antioxidants.

One way to diagnose this cancer is with the PSA blood test and the digital rectal exam which can lead to further confirmatory tests including a biopsy.

Other common cause of prostate symptoms include infection and an enlarged prostate.

Three recent patient cases help to illustrate the conversation and thought process when dealing with real life prostate cancer concerns as we all age.

Patient #1 had a strong family history where all the men in his family had prostate cancer diagnosed by the age of 65. As a 66 year old his PSA had been monitored annually and now was found to have a sharp spike rising from 3.9 to 6.4. Given the concerns here he was referred and had a biopsy done that was normal.  He will need to be followed closely for years to come.

Patient #2 has had an elevated PSA that dates back for five years and continues to increase very slowly. This 71 year old male does have symptoms of BPH and given a recent slight increase we have decided to check a PSA twice a year. As a 71 year old he is very healthy and we have decided that we will monitor his lab work and if any concerns he will be referred to a urologist.

Patient #3 is an interesting case and illustrates some of the complexities of this condition and its management. He is 78 and has recently been diagnosed with dementia. He has been followed by urology for some time and has been against getting a biopsy. Recent testing shows that his PSA has significantly increased and he most likely has prostate cancer. After detailed conversations with himself, family and his doctors the patient and family have decided that they do not want any further PSA testing and have elected to  be conservative with management of the prostate. This is partly related to  his overall history, wishes and his prognosis.  For all of these situations a personal decision needs to be made based on a lot of information.

None of these situations are simple and all come with specific risks and benefits. I can not overstate how important it is to have a clear conversation with the patient and if needed family as well.

Remember that antioxidants help. Consider our metagenics  Multivitamin  and Vitamin D  along with a balance diet.

Check in with your doctor and have that conversation.  Contact the office for a virtual conversation if needed or stop by the office.