High PSA: Prostatitis or Prostate Cancer? | Mark Scholz, MD | PCRI
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- Опубликовано: 7 ноя 2022
- In this video, PCRI's Alex and Dr. Mark Scholz discuss prostatitis, that is, inflammation of the prostate. Prostatitis can be symptomatic or asymptomatic, transient or chronic, and it can confuse PSA screening for prostate cancer by inflating PSA results. Here, they discuss how it is identified, if and when it is treated, how it is treated, and how it can potentially confuse PSA testing.
0:07 What is prostatitis and how is it interpreted and treated?
2:05 What causes prostatitis?
3:53 How do you tell the difference between prostate cancer and prostatitis when you are tracking PSA, for example?
5:52 If a person's PSA is bouncing up and down from prostatitis, what is the range you would expect? In other words, how high can the PSA go from a prostatitis bump?
8:47 What are the treatments that are available for urinary function?
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Excellent video. I like Dr. Scholz and his straight-forward conversational style. I wish he were my doctor!
Very helpful video clip 👍🏼
Great presentation … great interviewer
Thanks for this wonderful vid. May I ask: In a case in which man is diagnosed with chronic bacterial prostatitis which only flares up to urinary symptoms every few months or longer, what are the usual treatment alternatives? Is treatment with antibiotics during the symptomatic episodes standard practice? Thanks.
So glad I came across this channel, very informative. Here in UK it’s nearly impossible to get psa test, it’s all so contradictory, one group of medics say get a psa test , others say it’s a bit of a waste of time. Very frustrating.
@@maxim4458 Thank you.
This guy has great ties!
I’am glad my doctor sent me too a urologist after my physical this year . My PSA was high ,the urologist tested it again and it had raised a few more point’s in just 3 week’s since seeing my primary doctor. I was sent too get an MRI , which indicated several lessons of cancer .I’am now schedule for a biopsy to see how bad it is. I would never have known it , had it not been for PSA test . I hope it’s not too bad , so I’ll find out .
@@maxim4458 do you lose sexual function when prostate is removed?
@@maxim4458 thanks for the detailed answer!
Good luck my friend. I'm sending you energy to help you through this...one way or the other.
Would you mind sharing how the biopsy went?
I’m 55, first one was a few years ago
1.6, then the next year
2.1, then last year
5.15, tested again a
Few Months later
4.1 so it went down but too high for 55.
I just did a PR-MRI at Scripps Hospital in San Diego.
I have no urinary or erection problems whatsoever, just a high PSA for my age.
I’m reluctant to do biopsy for a list of permanent reasons
Will let us know what the results are for biopsy, bcs that is the case with me. Good luck my brother.
Please I asked a question about do we need a biopsy to validate if the scan shows bone Mets in prostate cancer
I’m wondering about prostate inflammation possibly causing both elevated PSA and a PI-RADS 5/6 (two separate opinions of same MRI). After MRI, I had a random biopsy which showed Gleason 6 (Grade 1) “cancer”. Then I had another MRI targeted biopsy which showed no cancer in the lesion, but did show the same Gleason 6 on a couple other cores Low percentages). I’m thinking active surveillance is best. I will have another PSA check at 6 mos.
Can inflammation cause both a false PI-RADS 5/6 lesion and high PSA?
My prostate is enlarged - and I’m wondering if Gleason 6 tissue is often found in association with enlarged prostates?? (Would be nice to know…)
I’m hoping Gleason 6 / grade 1 gets recategorized at “non cancer” so that I can get back to giving blood. So many things are impacted by this cancer label- including my own psyche!!
Thanks to all….
He talks about eliminating cancer to get at a diagnosis of prostatitis. Does that mean that you have to get a biopsy?
So I've had 6-8 uti's over past couple years. No psa bump. Active Surveillance for one year. Antibiotics, Cipro, took care of it. But what's cause of recurrence? My bicycle shorts?
Does inflammation and prostate cancer look the same on an MRI?
Is PSMA testing available even if he has not been diagnosed with prostrate cancer?
As a test for Prostatitus (which I suspect since I have Eczema). before my next PSA, could I take Aleve for a couple days prior and see what happens? It PSA drops, then Prostatius more likely?
I was thinking of trying the same thing. Did you find out if that works ?
@@shinola228 Tried it twice and my PSA held steady. Now I'm afraid not to take it before a PSA. An MRI I took, indicated that their was some Prostititus.
Hi im 65yrs young and my psa have been 12.4 for the last 14 months, My Urologist sent me for an MRI Scan and results came back inflammation and enlarged prostrate which is the reason for high psa, my Urologist told me i have prostatitis. Im still a little nervouse and asked for a biopsy but Urologist was against the idea as the biopsy needle had nothing to target in my prostrate.
My Dad and Grandad both passed away with prostrate cancer so it does cause a little anxiety.
I had a psa test again during the week 2 months after my last one so im hoping the psa reading has come down🙏🤞🏿 Results next week.
Dear friend, how's your latest situation?
@@edwardchow4176 blood test next month and check psa level, if still high reading it will be an appointment with Urologist towards end of February.
What are risk of sexual side effects and incontinent side effects from simple prostatectomy or other surgical treatments for BPH?
Thank you Dr. Mark and Alex,
I have a Gleason 8 and PSA that had been rising up to 16.6 then 11 and now 11.6 in the past few months, I'm 79 yrs., low BP and weight, non smoker, Army veteran.
I had a 3yr. bout of Valley Fever with daily Fluconozole till finally I beat it about a year ago. This drug seems the culprit for hair loss and finger nails brittle and breaking etc. Now that I am done with the Fluconozole My hair has returned to my previous vigorous growth and nails healthy once again. Could it be that my falling PSA and return also to much improved nail and urinary function is the absence of the Fluconozle? It is a very strong antifungal medicine.
With this in mind, could my cancer be retreating as my body has vastly improved and my immune system firing better?
Please advise as I'm about ready to go for a surgery or radiation in fear that the cancer will spread etc. Should I ask for another biopsy or go forward with a sorely needed spine repair job.
Please help!
Garyt,
SFVA patient.
My heart goes out to you in terms of your fear. What treatment did you have?x
What can you tell us about ExoDx urine test?
Can chronic prostatitis also affect free PSA?
A 1998 study and a 2004 study says yes, it does.
Should an 81 year old with consistent 2.5ish PSA continue to take Lupron long term? Meaning several years or for the rest of his life?
So you are in a difficult position if you have prostate cancer and chronic prostatitis at the same time for you can not tell which of them causes a rise in PSA and I find it particularly concerning that no treatment is used to deal with the prostatitis whether or not there is also cancer.
Have both BPH and low-grade prostate cancer myself, Gleason 3+3. Oddly even while on Flomax and Avodart for several yrs. my PSA has remained elevated, my latest reading being 11.2 (never seen this supposed 50% reduction in PSA reading with Avodart, although that is a generality and may not apply to everyone. Scheduled for an MRI early in the new year, so will see if anything new shows up.
Does PSA bounce with prostate cancer (i.e., 2 to 4 and back to 2)?
From my understanding No, unless you are Flomax, finasteride etc.... something that controls your PSA. Here's something not to many people know your testosterone levels and PSA go hand in hand.
Doctir if i antibiotics reduce ny symptoms and if my PSA is 0.14 does that mean i have prostatitis? Pls answer
It looks very much so, if you do have typical symptoms of prostatitis
@@hn5460 I have all symptoms so combined of mixed bhp, prostate cancer , and prostatitis. Sometimes they are stronger sometis they are not there I am 29 years old.
@@hn5460 or sometimes they change but I need to say that I use benzos and antidepressive
@@hn5460 I had 0.72 psa and bigger prostate but after 3 months my psa is 0.98 and the prostate is still a bigger that can be conclude cause bigger free PSA and index is good. I try to avoid going to hospitals because of COVID 19 and I am also imunocompromised so please just if you can tell me advice should I still monitor psa. One urologyst told me that we should monitor for now without digital rectal exam but what is your opinion as a doctor. Thank you in advance.
@@nikolapantelic7341 Your PSA levels are typical for men in their 40s and 50s and low for the 60+. Given the benign enlarged prostate you mentioned, I would not worry at all about the possibility of a clinical significant prostate cancer. The small increase in 3 months mostly due to the natural fluctuation of PSA levels.
IMO, at this PSA level, and with a history of BPH, you don't even need to monitor your PSA level, let alone to do it so frequently.
In short, you are safe from having a type of prostate cancer that may kill you. All you need to do is to take another PSA test sometime next year in Summer when COVID is low, and if the result is less than 1.2 then you can ignore the annual PSA monitoring and are still okay.
Your focus right now is not about prostate cancer but to build up and maintain your immune system: Following a vegan or Mediterranean diet, avoid sugar, exercise more, sleep well, reduce stress. Those are the things will help you live longer, healthier, not the monitoring PSA levels.
Is post finasteride syndrome real and if so what can be done about it?
Won't the percent free PSA differentiate between the two ?
No because free PSA can be impact by prostatitis as well.
@@goyo2897 Ok thank you
What about digital check prostate
Here is video explaining what a DRE (Digital Rectal Exam) is: ruclips.net/video/1fQI5b2yRlc/видео.html
If chronic prostatitis is cancer? My doctor gave me an ultrasound, urine, and digital rectal exam and told me I had chronic prostatitis.
Chronic prostatitis is not the same as prostate cancer. The two conditions can co-exist, but they are distinct conditions.
Hello jishan, where u consulted urologist?
& what was ur psa ?
U have non bacterial prostatis?
Can you talk about prostate cancers that don’t raise PSA much or at all? Are they more difficult to treat?
My PSA never got over 1 my whole life, then spiked to 9 six months after a TURP and then turns out I had stage 4B metastatic in most of the gland, a lymph node and multiple bones including pelvis and spine.
regret to hear your news....shocking 1 PSA's to 9 after TURP.....you suspect TURP was a factor?.....best wishes to you in a tough situation
@@emugglsu my thoughts were that the TURP damaged the prostate enough to be the cause of the rise in PSA. I was bleeding and passing clots for 3+ months after the TURP.
But…I’m sure the cancer was there before the TURP, probably long before it. I had severe BPH, including urine retention (why I got the TURP). I figure the ever growing cancer was causing the gland to bulge. I ended up needing ac second TURP 5 months after the first. The pre-op for that found the PSA of 9.
But your question sparked a continuation of that thought. Is it possible the first TURP broke the “prostate capsule” and released the cancer to be metastatic? The urologist saw “aggressive cancer cells” growing out of the prostate and into the bladder neck and bladder itself during the cystoscopy before TURP #2. Makes me think TURP #1 didn’t cause cancer, but let it out sooner than it would have.
My biopsy showed “ductal type” cancer. That type is known to not cause PSA rises, and some studies show it’s less responsive to standard treatments.
Thanks for the well wishes.
@@daveaultman7688 thx relaying your story....its testimony to even a low PSA of 1 can mask issues....does sound like hell broke loose after the procedure......are the docs providing you a path to beating this devil?
@@daveaultman7688how's your health now?
A ultrasound will show inflamation and proctitis very well 6:53 6:53 6:53 6:53 6:53