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Dr. Ben
Dr. Ben, Doctor
Category: Medical
Satisfied Customers: 1061
Experience:  GP Partner, practicing Medicine for 14 years. I have broad experience with special interests in Dermatology, Paediatrics, Sexual Health and Oncology.
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Psa 4.1 week ago. Doctor said to retest in couple of months.

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Psa 4.1 week ago. Doctor said to retest in couple of months. Physical examination identified enlarged prostate. I know psa fluctuates. Once was 7, then back to normal. Previous year in normal range. Frequent urination at night.
Age 68.
What are your thoughts?

Hello, thank you for your question. I’m Dr. Ben and I’m here to assist you today. Please allow me a few moments to review your question and I’ll be right back.

If you receive an invitation for a phone call, please know this is automatically generated by the site and has not come from me. Feel free to ignore it.

This really depends on your attitude to risk and being able to make an informed decision based on knowledge of the limitations of PSA testing and what further investigation/treatment involves.

With a PSA value of 4.1ng/mL, we can calculate an approximate risk of being able to detect prostate cancer following further investigation (prostate biopsy +/- MRI scan) of 15%.

However, it is important to understand that not all prostate cancers are the same - the majority are slow-growing and will never seriously threaten health. The treatment of these sorts of cancer can actually cause more problems than the cancer ever would have if it was just left alone.

The risk of detecting a ‘clinically significant’ cancer (i.e. one that is faster-growing and would have a detrimental effect on health if left untreated) is 4% (a 1 in 25 chance) and this is the figure you should bear in mind when making a decision.

Is there anything else you would like to ask me?

Customer: replied 13 days ago.
Thank you
Would an enlarged prostate cause the PSA to raise?
The fact that it was 7 in the past and then back to normal means what?

Yes, natural age-related enlargement of the prostate causes the PSA to rise.

PSA is released from irritated prostate cells and cause the level to be artificially raised, such as in the presence of an infection or even vigorous exercise.

Is there anything else you would like to ask me?

Customer: replied 13 days ago.
Would you recommend just retesting in couple of months? If the doctor would have been concerned based on history and physical examination, he would have discussed further tests I suppose?

Yes, this would be the most typical approach with an escalating PSA level over the course of a few months making further investigation advisable.

Does this help?

Customer: replied 13 days ago.
Yes thank you

You’re very welcome, all the best.

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