Prostate Health

Prostate Health Specialist
Elizabeth Kavaler, MD & Lauren B. Schulz, DO at Total Urology Care of New York provide urology services to patients in Midtown West Manhattan and the surrounding areas. They help patients with their prostate health, including elevated PSA and enlarged prostate.

Prostate Health Q & A

Total Urology Care of New York

What Is a high PSA level?

There isn’t a definitive answer to this question because the health community has not decided upon a normal PSA level. In the past, a doctor would recommend a prostate biopsy if the PSA was at least 4.0 ng/mL, but doctors do not always follow this guideline anymore as the understanding of PSA has been changing.

How is a PSA screening test performed?

The PSA screening test usually requires that the patient give a blood sample. The blood is then sent to a lab where it will be examined and results are usually returned within a few days. His consultation will involve an evaluation of the PSA level taken in the context of the man’s previous PSA levels, and whether or not there are signs of an infection or inflammation of the prostate as the presence of these can cause a benign elevation of the PSA.  In addition, a digital rectal examination will be performed during the office examination to feel for any hard to suspicious area in the prostate that may suggest the presence of a tumor.  It is also important to factor in possible prostate cancer risk factors a patient may have when interpreting PSA results such a family history of prostate cancer.

Does an elevated PSA mean I have cancer?

In some cases, men who have prostate cancer have high PSA levels, so health professionals often use blood PSA measurement as a cancer screening. However, this level does not always indicate cancer. Men with prostate cancer have had PSA levels lower than 4.0 ng/mL. In addition, plenty of men have had elevated PSA numbers and not had prostate cancer. A higher PSA level is a risk factor for cancer but does not seem to determine cancer on its own. Instead, other risk factors are involved. Instead of cancer, a high PSA level could mean you have inflammation in your prostate gland or an enlarged prostate. Checking the PSA level on a regular basis can also be helpful in managing low-risk prostate cancer, which does not necessarily need treatment.

What if I have already had prostate cancer?

Your urologist will check your PSA level on a regular basis if you have previously had prostate cancer and went through treatment. In this case, a higher level might show that cancer has come back. Your doctor would give you more tests to be certain about a recurrence of prostate cancer.

 

What is an enlarged prostate?

The prostate normally has two stages of growth, the second of which is ongoing as the man ages. Although benign prostatic hyperplasia (BPH) happens in the second stage of growth, which starts when a man is about 25, this condition is different from the normal growth. As the word “benign” in the name suggests, this condition does not designate cancer. The enlarged prostate puts pressure on the urethra and leads to thickening of the bladder wall. If the condition continues, you could have trouble completely releasing all of the urine from your bladder.

What are causes and symptoms?

You could have this condition if you have various problems with urination. You could be unable to hold urination, urinate at least eight times per day, urinate when you don’t mean to, or experience urine with a different odor or color than normal. Or you could experience difficulty urinating with trouble beginning, holding urine, or dribbling when finished. You could also have an abnormal urine stream or painful urination. Health professionals do not fully know what causes BPH. They think it might involve the reduction of active testosterone that happens with the aging process. This could leave a larger percentage of estrogen, which might encourage the prostate to grow. Researchers also theorize that the male hormone DHT or the testicles could be involved because men with removed testicles and men whose bodies don’t create DHT do not get this health condition.

What are treatments?

Not every man needs treatment for benign prostatic obstruction – it depends on how severe his symptoms are. Treatment for BPH is set by the severity of the symptoms and whether the individual is experiencing any complications. If you do need treatment, it could vary based on your specific symptoms and other factors. Your doctor might suggest you take medication and/or make changes to your lifestyle. Sometimes, a minimally invasive procedure or surgery will be necessary

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