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Suggest Remedies For Elevated PSA Levels

Posted on Thu, 28 Apr 2016

Question: hi doctor, my father is 72 years old.
he was diagnosed with prostate enlargement and a temporary infection a few years back. from then he was taking urimax-d and things were under some control. now last month the infection brought fever too. a doctor of medicine suggested a PSA test. the result was alarming ( 45.82 ng/ml) . i planned to consult a urologist. the second test of PSA and free PSA resulted a little lower count ( 14.600 ng/ml ). and a third test a few days back resulted ( 3.910 ng/nl with free psa 0.671 ng/ml ). now a urologist has prescribed SILOFAST - D8 in place of urimax. and to my XXXXXXX , the urine flow has decreased after taking this new capsule. this urologist has also suggested a Uroflowmetry. please suggest.

Answered by Dr. Prof. Kunal Saha (2 hours later)

Brief Answer:
The approach seems proper. Continue follow up as directed.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone through your query and the report and understand your concerns. PSA usually rises in case of prostatic pathology but a lowering clears the apprehensions about ominous issues like prostate cancer. However, periodic monitoring of the PSA levels would be needed. You need to keep him under the follow up of the urologist. He has done the right thing by suggesting uroflometry to be done. Based on that decision for further intervention can be taken. Please continue to give him the prescribed medicines in the meantime.

Feel free to write back to me in case of further queries.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (6 minutes later)

thanks for your answer, sir.

which test or sign may confirm a cancer better?
is it better to take him to a better medication now? or just follow what
the urologist suggest ! please guide.

Answered by Dr. Prof. Kunal Saha (28 minutes later)

Brief Answer:
Get the uroflometry done and intervene accordingly.

Detailed Answer:
Thanks for writing back.

Prostatic biopsy followed by histopathological examination is the best option for diagnosis of cancer but I do not think it to be needed right now. Wait for uorflometry and keep him on periodic PSA monitoring. Discuss the options with your urologist. I would insist on continuing the medicines as of now.

You can continue under the guidance of the same urologist whom you are seeing at present.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (32 hours later)

can you kindly educate us about the precautions and food-restrictions for my father? he is taking urimax-4 and silofast-d8 at night. i shall share the uroflometry report as it is done, sir.

thanks.

Answered by Dr. Prof. Kunal Saha (50 minutes later)

Brief Answer:
No specific precautions.

Detailed Answer:
Thanks for writing back. Incidentally there is no specific precaution that needs to be followed in terms of food habits. All he needs to do is to take limited amount of water before going to bed. The food should contain plenty of dietary fibers.

Let the medicines continue. Feel free to ask me back for any health related query in the future.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (2 days later)

hello sir,

here is the UROFLOWMETRY report,

voided volume: 0293 ml. XXXXXXX flow rate: 018.5 ml/sec
average flow rate: 007.0 ml/sec
flow time: 036.0 sec
time to XXXXXXX flow: 010.0 sec
voiding time: 041.6 sec
hesitancy: 00.00 sec

please guide with your views on it.

Answered by Dr. Prof. Kunal Saha (14 hours later)

Brief Answer:
Flow significantly reduced.

Detailed Answer:
Thanks for writing back. Sorry for the inadvertent delay in replying.

The average flow rate for normal males of this age is 9 ml/sec. So it is significantly reduced. You would have to discuss the options with your urologist and he would be able to point out if trans-urethral resection of prostate (TURP) is advisable or whether a surgical biopsy is recommended.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (6 hours later)

is it alarming, sir? actually my urologist visits my town once in a month. next date is on 3rd march. so bit confused. if it's urgent i can find the urologist's place and discuss the report. please guide.

Answered by Dr. Prof. Kunal Saha (11 hours later)

Brief Answer:
You can wait for the urologist to visit.

Detailed Answer:
Thanks for writing back. You can wait till 3rd March to consult him. Unless your father's passage of urine gets stuck, you can wait.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar