Q: I am a 68-year-old man in good health apart from a high PSA level. A number of biopsies all came back normal.
Does this mean that I have prostate cancer but they are unable to find it with the needle biopsies? Should I ask the doctorsto remove my prostate gland to be on the safe side?
A: The prostate gland produces a special type of protein known as prostate specific antigen or PSA.
Testing the blood for elevated readings is a way of finding out if a man has prostate cancer.
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Although there is some disagreement among doctors on how much is too much, they will usually perform a biopsy if the levels are higher than four nanograms per millilitre of blood. There seems to be a small number of men with high PSA levels who do not have cancer of the prostate.
A research article published in the Journal of the National Cancer Institute by Scott Cramer and associates shows that a small chemical change in the genes responsible for PSA production can affect its levels in the blood.
Researchers felt that if this genetic type could be identified ahead of time, it could save men unpleasant and unnecessary biopsies.
Your urologist will probably not agree to remove your prostate gland “to be on the safe side” because there are some risks involved in the surgery.
If the biopsies are clear and the prostate is normal on physical examination, not enlarged or lumpy and not obstructing the flow of urine in any way, you should carry on with your life and continue to get annual checkups.
Clare Rowson is a retired medical doctor living near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor. She can be reached at health@producer.com.
